What is fatty liver?
Fatty liver means extra fat has built up inside liver cells. Doctors now often call the most common type MASLD (metabolic dysfunction-associated steatotic liver disease). It is linked to belly fat, diabetes, high cholesterol and blood pressure, rather than alcohol. Alcohol can cause fatty liver too.
In many people, the fat just sits there. But in some, it causes inflammation and slowly leads to scarring (fibrosis). Over many years, heavy scarring can become cirrhosis. The key question after a fatty liver report is therefore: is there any scarring?
Early signs: mostly none
Fatty liver is usually silent. Most people find out by chance, from an ultrasound done for something else, or from a routine blood test showing raised liver enzymes (SGPT/ALT, SGOT/AST). When there are symptoms, they're vague:
- Tiredness and low energy
- A dull ache or heaviness under the right ribs
- Feeling bloated or full
More useful than symptoms are the risk signs you can see and measure:
- A waist size above about 90 cm (men) or 80 cm (women), which are commonly used cut-offs for Asian adults
- Diabetes or prediabetes, high triglycerides or low HDL cholesterol
- High blood pressure
- Dark, velvety skin patches on the neck or armpits (a sign of insulin resistance)
- Snoring and daytime sleepiness (sleep apnoea), and PCOS in women
Signs that need urgent attention
- Yellow eyes or skin, or very dark urine
- Swelling of the belly or legs
- Vomiting blood or passing black stools
- Confusion or unusual drowsiness
These suggest advanced liver disease and need prompt medical care. Call 93196 62944 (24×7).
What your ultrasound report means
Ultrasound grades (grade 1, 2 or 3) describe roughly how much fat is visible. They do not measure scarring. A person with "grade 1" fatty liver can have more scarring than someone with "grade 3". Ultrasound also can't reliably detect early fibrosis. That's where FibroScan comes in.
What is a FibroScan?
A FibroScan is a quick, painless scan that measures liver stiffness (in kPa, a marker of scarring) and liver fat (the CAP score). You lie on your back, a probe is placed over the right ribs, and you feel light taps. There are no needles and no radiation, and it takes about 10–15 minutes. You usually need to fast for about three hours beforehand.
When should you get a FibroScan?
Not everyone with fatty liver needs one straight away. Doctors often first calculate a simple score from routine blood tests (such as FIB-4). A FibroScan is especially worth discussing if you have fatty liver and:
- Type 2 diabetes, which raises the risk of scarring
- Obesity, particularly with other metabolic problems
- Raised liver enzymes for more than a few months
- A blood-test score suggesting possible fibrosis
- Regular alcohol intake
- Hepatitis B or C
It is also useful for tracking progress. Seeing your numbers improve after losing weight can be very motivating.
How to reverse fatty liver: what really works
- Lose 7–10% of your weight slowly (about 0.5–1 kg a week). Even 5% reduces liver fat.
- Cut sugar and sweet drinks, including fruit juices, cold drinks, and sugar in tea.
- Reduce maida and fried snacks: bhature, samosa, biscuits, namkeen.
- Fill half your plate with vegetables, and include protein (dal, chana, paneer, eggs, fish).
- Walk briskly 30–45 minutes on most days, and add simple strength exercises.
- Avoid alcohol, and don't take "liver detox" supplements without medical advice.
- Control sugar, BP and cholesterol with your doctor.
The bottom line
Fatty liver is common and usually silent. Treat your ultrasound report as a nudge to act, not a reason to panic. Find out whether there's any scarring, with blood-test scores and a FibroScan where appropriate, and start small, steady lifestyle changes. At Samrijo Hospital in Burari, liver tests, ultrasound and fatty liver care are available close to home.