5 Signs and Symptoms of Fatty Liver Disease

Medically Reviewed By William C. Lloyd III, MD, FACS
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  • Many people realize excessive drinking can cause liver disease, but not everyone knows a fatty diet by itself also can damage the liver in both adults and children. Fatty liver disease symptoms not due to alcohol consumption appear very similar to alcoholic liver disease and can cause equally severe liver damage.

    Left untreated, nonalcoholic fatty liver disease (NAFLD) can progress to the more serious condition nonalcoholic steatohepatitis (NASH) and even total liver failure. Unfortunately, NAFLD rarely exhibits symptoms until it’s severe. Learn the signs and symptoms that can indicate fatty liver disease—and when to see a doctor.

  • 1
    Pain in the Upper-Right Abdomen
    man with abdominal pain clutching stomach with hands

    The liver is the body’s largest vital organ; it occupies space behind the lower portion of the right rib cage. One of the few symptoms of fatty liver disease, especially in children, is pain in this general area, usually in the upper-right quadrant of the abdomen, just below the rib cage. The pain occurs when fatty liver disease progresses to inflammation and enlargement of the organ (NASH), which stretches the capsule (the liver’s covering) to cause discomfort. However, many conditions can cause pain in the same area, including appendicitis and gallstones, so consult a healthcare professional to evaluate this symptom.

  • 2
    Unexplained Fatigue
    Senior Caucasian woman at edge of bed holding head with headache or fatigue

    Tiredness may be the most common symptom reported to doctors. Unexplained fatigue can be symptomatic of hundreds of conditions and, as a symptom of fatty liver disease in adults, tiredness again makes the list. Your doctor likely will first try to rule out simpler explanations for fatigue before progressing to a diagnosis of fatty liver disease, unless you exhibit other symptoms like right upper-quadrant pain, or if you’re at high risk for fatty liver disease due to obesity, high cholesterol, family history, or heavy drinking.

  • 3
    Elevated Liver Enzymes
    doctor holding liver function test result showing bilirubin level

    If you have type 2 diabetes, metabolic syndrome, or another condition associated with fatty liver disease, your doctor may perform a blood test to determine if you have NAFLD—even if you don’t have symptoms. Elevated levels of the enzymes aminotransferase (ALT) and aspartate aminotransferase (AST) indicate liver dysfunction of some kind, which could be caused by fatty liver disease. Your healthcare provider will consider these test results in combination with your personal history, current physical condition, risk factors and the results of additional tests before confirming a diagnosis of NAFLD or fatty liver disease due to alcohol.

  • 4
    Visible Fat in the Liver

    Imaging tests like ultrasound and MRI can create pictures that show whether fatty deposits exist in your liver. Fatty buildup in the liver is a clear-cut sign of fatty liver disease. But imaging tests can’t detect the presence of inflammation or the development of scar tissue, which indicate how far the disease has progressed. For that your doctor may need to obtain a tissue sample (biopsy).

  • 5
    Liver Inflammation and Fibrosis
    concept illustration of obese man with fatty liver, showing inset of microscopic liver damage

    As nonalcoholic fatty liver disease progresses, it can lead to liver enlargement, inflammation and fibrosis (scar tissue development). This is nonalcoholic steatohepatitis (NASH). To diagnose NASH, doctors biopsy the liver. The presence of inflammation or scar tissue in the sample indicates NASH. If you have been diagnosed with NAFLD, you can reduce your risk of NASH by losing weight, eating a heart-healthy diet, and exercising regularly to keep your liver functioning as well as possible.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jun 1
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