Fatty liver, also known as Liver steatosis occurs when there is an imbalance in fat handling by the liver. Fat droplets accumulate in the liver cells and cause it to appear more ‘echogenic’ (brighter/whiter) on the ultrasound scan.

There are 2 types of fatty liver:

1. Nonalcoholic fatty liver - fat build up in the liver not linked to drinking alcohol.

2. Alcoholic fatty liver - fat build up in the liver linked to drinking excessive daily

Non-alcoholic fatty liver is caused by –

1. Obesity: This is the most common cause of fatty liver

2. Diabetes mellitus (adult-onset type 2): This is an important factor because although the levels of insulin in the blood are high, their function is impaired,  due to a condition called “Insulin resistance’. This is turn increases blood pressure, increases triglycerides and causes fatty liver

3. Having metabolic syndrome: Combination of excess body weight with insulin resistance with high blood pressure and high blood cholesterol levels.

Fatty liver usually has no symptoms. Sometimes, if the liver is enlarged there can be slight discomfort felt in the right upper abdomen.

Usually it does not cause any serious problem in most people but one should consider this finding as a first warning to be aware about your:

1. Bodyweight
2. Blood sugar levels
3. Blood cholesterol levels
4. Blood pressure
5. Alcohol intake

Also, 10-20% of people with fatty liver might develop steatohepatitis - a more severe form in which liver function gets affected.

• Ultrasound scan whole abdomen: This will check the texture and size of the liver and grade fatty liver as Grade I, II or III. It will also tell us if the surface is smooth or nodular.
• Fibro-scan liver: It checks and measures the fibrosis (scarring) and steatosis (fatty change) in the liver. Used as additional test to ultrasound scan.
• Blood tests: Liver function tests (GOT or GPT; also called AST and ALT) l, blood sugar, blood cholesterol levels etc will need to be checked also.

Yes. Maintain the following:
1. Healthy weight - If overweight, lose weight gradually.
2. Alcohol should be limited or avoided.
3. Exercise regularly to maintain healthy blood pressure, blood sugar and cholesterol levels.
4. Get a complete annual health check-up including blood tests in a fasting state. If required, do an ultrasound. If a previous ultrasound has revealed a fatty liver, it is important to do a whole abdomen follow-up and see the progression/regression. The severity of fatty liver on ultrasound correlates with the risk of metabolic syndrome, diabetes mellitus and heart disease.

There is no single treatment for fatty liver. We need to treat the underlying cause as mentioned in the preventive measures above, thereby treating the fatty liver.