A fatty liver refers to a collection of too much fat in liver cells that often occurs in patients with diabetes or obesity or patients who drink too much alcohol. A fatty liver by itself is not harmful, but prolonged swelling (inflammation) of a fatty liver can lead to scarring (cirrhosis) and poor functioning of the liver.
Nonalcoholic fatty liver disease (nonalcoholic steatohepatitis, or NASH) is inflammation of a fatty liver that is not caused by alcohol or hepatitis. It is more common in overweight people, but the specific cause is unknown. NASH is not transmitted from person to person or from generation to generation. NASH is the most common liver disease in teenagers and the third leading cause of liver disease in adults.
Most patients with fatty liver or NASH do not know they have it because they usually have no symptoms. Some patients may feel tired or have pain and discomfort in the abdomen (belly), if the liver is much larger than normal.
The health care provider may make this diagnosis by accident when testing for another complaint. Often, liver function blood tests, done as part of annual or routine blood work, show results are not normal. In this case, the health care provider will take a detailed history and do a physical examination and other studies to rule out common causes of these abnormal results (such as hepatitis, alcohol, or too much iron in the liver). At an examination, the health care provider may feel for a liver or spleen that is too large but in most cases this will not be evident on physical examination.
The health care provider may also want special x-ray studies and scans of the liver: ultrasound scan, computed tomography (CT), or magnetic resonance imaging (MRI).
If necessary, a diagnosis of NASH is proved by a liver biopsy. In a biopsy, a large needle is inserted into the liver. Then, a small piece of the liver is removed and examined under a microscope. This test is rarely done for diagnosing fatty liver and is only performed to exclude more severe diseases when the diagnosis is unclear.
Weight loss and avoiding alcohol are the best ways to treat fatty liver.
If you have NASH and are obese or diabetic or have high cholesterol, you should lose weight and control your blood sugar and lipid levels by eating a good diet and exercising.
Your health care provider may try drugs to reduce the liver’s fats and inflammation.
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