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Fatty Liver - Symptoms, Grades, and Diagnosis

Author: Dr. Vasantha K S - liver diseases  

The liver is the largest gland in the body. Its primary function is to process the food and drinks we consume and filter out the harmful substances. A certain amount of fat is normal if present in the liver. But due to various factors, excess fat can start accumulating in the liver. Initially, there will not be any symptoms. But, it does not affect the efficiency of the liver functions.

The body has some mechanisms in place to allow the liver cells to regenerate. But, repeated damage can cause permanent scarring in the form of cirrhosis.


  1. Alcoholism.
  2. Overeating as a habit.
  3. Medical conditions such as diabetes, obesity, high triglycerides, high blood pressure.
  4. Certain medications (Aspirin, steroids, methotrexate, etc.)
  5. Rapid weight loss.
  6. Liver infections like hepatitis C.


  • Alcoholic fatty liver disease: It is the damage caused to the liver cells due to excess alcohol consumption.
  • Non-alcoholic fatty liver disease (NAFLD): It is caused due to the other factors mentioned above in a person who does not consume too much alcohol.


Initially, there are no symptoms felt by the patient. But, there is a slight enlargement of liver detected during a physical examination. Later, once there is excessive inflammation, vague symptoms may develop such as:

  • Decreased appetite.
  • Weight loss.
  • Fatigue.
  • Abdominal discomfort.
  • Pain in the upper right abdomen.

Further, it can progress to cirrhosis and give rise to the following symptoms:

  • Jaundice.
  • Ascites (abdominal swelling).
  • Edema.
  • Confusion.
  • Increased bleeding tendency.

Grades of Fatty Liver

Based on the visual changes observed on the ultrasound, the fatty liver is graded into three:

Grade I - This is the mildest form. Here, the fat accumulates on the outside of the organ and does not affect its function.

Grade II - It is a moderately severe form and requires medical intervention to prevent worsening.

Grade III - It is the severe form of fatty liver, with the appearance of symptoms. Active treatments are required.


In the early stages, as mentioned above, there are no symptoms. So, it is often diagnosed during routine blood tests. The doctor can palpate the abdomen area to feel for changes, and he/she may suggest tests such as the following to confirm his finding:

- Blood tests to detect the levels of liver enzymes.

- Imaging tests such as ultrasound, CT or MRI.

- Liver biopsy where a needle is inserted and a sample tissue is taken out for testing. This is the most certain method to detect fatty liver.


  1. Alcohol abstinence.
  2. Dietary modifications.
  3. Weight loss.
  4. Diabetic control.
  5. Triglyceride control.


  • Healthy diet.
  • Healthy weight.
  • Exercise.

For more information consult a fatty liver specialist online --> https://www.icliniq.com/ask-a-doctor-online/medical-gastroenterologist/fatty-liver

Image: Fatty Liver - Symptoms, Grades, and Diagnosis Last reviewed at: 07.Sep.2018



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