What is fatty liver disease?

The liver is the body’s main organ for processing food and waste materials.

A healthy liver contains very little or no fat. If you drink too much alcohol, or eat too much food, your body deals with this excess by turning some of the calories into fat. This fat is then stored in liver cells.

The fat in liver cells can build up. If there is too much, you have fatty liver.

Fatty liver is becoming more common throughout the Western world because we are eating too many added sugars and added fats.

What causes fatty liver disease?

Fatty liver can be caused by drinking too much alcohol over long periods. However, most people with fatty liver have ‘non-alcoholic fatty liver disease’ (NAFLD), which is not caused by alcohol.

About 1 in 3 Australians has fatty liver. It is more common in people who:

• have high blood pressure
• have high cholesterol and high triglycerides
• have type 2 diabetes or look like they will develop it
• are overweight, especially around the abdomen

A few people have fatty liver due to other diseases, such as polycystic ovary syndrome (PCOS), chronic hepatitis B, chronic hepatitis C or haemochromatosis (a genetic abnormality of iron storage) or reactions to drugs such as kava or medicines such as steroids or chemotherapy.

Some women can also develop fatty liver because of complications that develop late in pregnancy.

How is fatty liver disease diagnosed?

Because fatty liver often does not cause any obvious symptoms, you may not know you have it until a routine test shows signs of a liver abnormality.

Your doctor will diagnose fatty liver by talking to you first, then examining you. You may be asked to have a blood test called a liver function test to see the health of your liver. You may also be asked to have a scan such as an ultrasound or an MRI scan.

If the tests show you have fatty liver, then you may need some other tests to look further into your health.

Depending on the results of the tests, your doctor may suggest that you see a specialist (gastroenterologist). In severe cases, a specialist may organise a biopsy of your liver to confirm the diagnosis and assess how severe the disease is.

What are the complications of fatty liver disease?

In many people, fatty liver by itself doesn’t cause too many problems. But in some people the fatty liver gets inflamed. Over time, this slowly gets worse and leads to scarring of the liver, which can lead to cirrhosis. This is a serious illness.

A few people who get cirrhosis of the liver develop liver cancer.

Fatty liver can be a sign of too much alcohol, but in most cases, it is not alcohol-related. This is called ‘non-alcoholic fatty liver disease’ (NAFLD ). Very often, fatty liver is a sign of other problems like diabetes or metabolic syndrome.

People with fatty liver have an increased risk of heart attack and stroke. Fortunately, there are ways to treat fatty liver and reduce the problems it causes.