Regional Gastrointestinal Consultants

Fatty Liver

Fatty Liver

Fatty Liver


Other names for Fatty Liver disease are hepatic steatosis or steatohepatitis. Fatty liver is an abnormal accumulation of certain fats (triglycerides) inside liver cells. People with fatty liver may feel tired or have mild abdominal discomfort but otherwise have no symptoms. A liver biopsy may be needed to confirm the diagnosis and to determine the cause and extent of the damage. Doctors focus on controlling or eliminating the cause of fatty liver, such as metabolic syndrome or consumption of large amounts of alcohol.

In the United States and other Western countries, the most common causes of fatty liver are:

  • Consumption of large amounts of alcohol
  • Obesity
  • Toxins
  • Side effects of certain drugs such as opoids Hereditary metabolic disorders
  • Metabolic abnormalities, such as excess body weight, insulin resistance (as can occur in diabetes), and high levels of triglycerides (a fat) in the blood

The combination of excess body weight, insulin resistance, and high triglyceride levels is called metabolic syndrome. All of these conditions cause fat to accumulate in liver cells by causing the body to synthesize more fat or by processing (metabolizing) and excreting fat more slowly. As a result, fat accumulates and is then stored inside liver cells. Just consuming a high-fat diet does not result in fatty liver. Rarely, fat accumulates in the liver during late pregnancy. This disorder, called fatty liver of pregnancy or microvascular steatosis, is usually considered a different disorder from fatty liver.

The main causes of fatty liver include obesity, high dietary intake of saturated fats, excessive alcohol consumption, and diabetes mellitus. Liver damage associated with fatty liver is common in people who drink alcohol excessively (alcoholic steatohepatitis), but also occurs in the absence of excessive alcohol (non-alcoholic steatohepatitis or NASH). Less common causes include pregnancy, some medications (e.g. corticosteroids), and many metabolic and other diseases.


Fatty liver usually causes no symptoms. Some people feel tired or have vague abdominal discomfort. The liver tends to enlarge and can be detected by doctors during a physical examination. The typical patient with fatty liver is overweight, eats too much (particularly fatty food), drinks too much alcohol, and does not exercise enough. Usually the symptoms are minor (discomfort in the upper abdomen on the right side), or there may be no symptoms. Often the only abnormality is raised liver enzymes. Treatment

Fatty liver is often a lifestyle disorder and treatment involves counselling about diet, weight reduction, and a safe level of alcohol consumption. It is important to test for and treat diabetes mellitus. The outlook for most patients is good, although it is common for some degree of liver enzyme abnormality to remain, and a small proportion of patients will develop cirrhosis.

The diagnosis is usually made by recognizing the typical clinical presentation and excluding other diseases such as chronic viral hepatitis, autoimmune chronic active hepatitis, hemochromatosis, and reactions to medications. If there are minimal symptoms, there is no evidence or liver dysfunction or failure, and the liver enzymes are only mildly raised, it may be adequate to advise dietary and other changes and observe the patient.

A liver biopsy is required if there is any doubt of the diagnosis, or if there is clinical and laboratory evidence of significant liver dysfunction. An ultrasound of the liver is useful, demonstrating increased echogenicity (increased density of the echos reflected from the liver) and excluding tumors and biliary obstruction. However, fatty liver is not the only cause of increased echogenicity (excess iron is another).


  • Control or elimination of the cause
  • Treatment of fatty liver focuses on controlling or eliminating the cause of fatty liver. For example, people should
  • Stop taking any drug that could be causing fatty liver
  • Lose weight
  • Take measures to control diabetes or lower triglyceride levels
  • Stop drinking

Vitamin E and thiazolidinedione’s (such as rosiglitazone or pioglitazone, used to treat diabetes) may be of some help in treating fatty liver that is not caused by alcohol.


We recommend that people experiencing gastrointestinal symptoms do not attempt self-treatment. With many medications being available over the counter, and numerous do-it-yourself online unqualified remedy recommendation, it is natural to consider treating yourself but we highly recommend against this.

If you are experiencing gastrointestinal symptoms you may have a more significant issue than you would expect from the sometimes muted or infrequent symptom you may be experiencing. It is important to keep in mind that is you are having gastrointestinal symptoms or concerns it is best see a doctor to have those symptoms diagnosed and any conditions treated. Also, it is worth noting, that if health conditions do exist, the earlier they are diagnosed and treated, the greater the probability will be to successfully eliminate or manage a present condition, in fact successful outcomes will increase significantly with early detection.

If you have gastrointestinal concerns or are experiencing any gastrointestinal symptoms, please contact us promptly to schedule a consultation with a physician.


The information on this website is to provide general information. In no way, does any of the information provided reflect definitive medical advice and self-diagnoses should not be made based on information obtained online. It is important to consult a best in class physician regarding ANY and ALL symptoms or signs as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today at (215) 321-4700 to schedule a consultation.