A dull pain under the ribs. A lot of people don’t notice the early signs that their liver is sending.
Doctors say that fatty liver disease, which used to be rare and mostly caused by heavy drinking, is now spreading quickly among people with normal lives. The disease can get worse without anyone noticing for years, and by the time symptoms show up, the liver may already be in a lot of pain.
Why fatty liver is becoming more common
When too much fat builds up inside liver cells, it causes fatty liver disease. That fat slowly messes up how the organ works.
Hepatologists say that the liver does more than 500 things, such as filtering out toxins and helping to control blood sugar and cholesterol levels. When fat builds up in the liver, those jobs stop working.
People often call the liver a “silent organ” because it doesn’t hurt most of the time, even when it’s already hurt.
Experts say that a well-known group is more likely to get hurt:
People who are overweight or have a lot of fat around their waist
People who have type 2 diabetes or are at risk of getting it
Anyone who has high blood pressure
People who have high triglycerides or cholesterol
People who drink alcohol often, even in “social” amounts,
Routine blood tests and an ultrasound of the abdomen often show the problem before symptoms show up. That early window is when changes to your lifestyle can have the biggest effect.
The six most common signs of fatty liver
Some people start to feel clear warning signs as the disease gets worse. A top liver doctor lists six signs that should be looked at.
1. Always being tired, even when you don’t have to be
It’s normal to feel tired after a long week. It’s different to feel tired even after a good night’s sleep.
People with fatty liver often say they feel very tired all the time. They might have trouble doing everyday things, lose interest in working out, or feel mentally foggy.
If you are always tired, even when you are getting enough sleep and not too stressed, it could mean that your liver is not processing energy and toxins correctly.
2. Some pain or discomfort on the right side of the belly
The liver is located beneath the right rib cage. Some people feel a dull ache or a sense of fullness in that area as it gets bigger or inflamed from fat buildup.
Most of the time, this pain isn’t sharp or unbearable. Because of that subtle quality, it’s easy to ignore and blame posture, gas, or muscle strain. A medical check is a good idea if the feeling keeps coming back.
3. Feeling sick and queasy, especially after eating
Nausea that happens a lot, especially after eating heavy or rich foods, could mean that your liver is overworked and having trouble digesting and metabolising food.
Some patients say they still feel sick, have lost their appetite, or push food away sooner than usual. Many digestive problems can make you feel sick, but if you have nausea that comes back along with other symptoms on this list, it’s a red flag.
4. Feeling bloated and having a “heavy stomach”
People with fatty liver often say that their stomachs swell up or they feel heavy all the time after eating even small amounts.
This could be because digestion is slower, the body processes fats and sugars differently, and in more advanced disease, fluid builds up in the belly. If your clothes feel tighter around your waist for no clear reason, you should pay attention to it.
5. Having trouble digesting fatty foods
When the liver is covered in fat, meals high in fried foods, cream, processed meats, or fast food can make you feel very bad.
Patients say they feel “knocked out” after these meals, with burning, belching, or the feeling that food stays in their stomachs for hours. Many people start to avoid certain foods without even thinking about it because they make them feel so bad afterward.
When the liver is overloaded, it has a hard time breaking down dietary fat, which makes greasy foods feel like a direct hit to the body.
6. Blood tests show liver enzymes that have changed
Routine blood work may be the most objective warning sign. People who feel fine can still have high levels of liver enzymes like ALT (TGP), AST (TGO), and GGT.
ALT (TGP): Damage or irritation to liver cells
AST (TGO) Stress in liver and muscle cells
GGT: The effect of alcohol or medicine on bile flow and the liver
Abnormal results alone do not confirm fatty liver; however, they frequently lead to an ultrasound or additional testing, which can indicate fat accumulation.
From quiet fat to a serious illness
If not treated, fatty liver can lead to inflammation, scarring (fibrosis), and, in some cases, cirrhosis. At this point, the liver gets stiff and stops working, which can cause liver failure and raise the risk of liver cancer.
The most surprising part is that this whole process can happen to people who don’t drink much alcohol, mostly because they are overweight, have type 2 diabetes, and don’t move around much.
Experts think that as many as one in four adults around the world may have some level of fatty liver, and they may not even know it.
What doctors say is the best way to treat it
Experts all agree on one main point: changing your lifestyle is the most important part of treating fatty liver disease. There is still no pill that is specifically approved for regular use to treat fatty liver.
Endocrinologists and hepatologists stress that losing weight in a steady, realistic way makes a difference that can be measured. Studies indicate that a reduction of approximately 7% of body weight can initiate the decrease of hepatic fat, with additional advantages as weight loss progresses.
Things you can do to help your fatty liver get better
Slowly losing weight: Instead of crash diets, which are hard to stick to, try to lose weight in small, steady amounts.
Real, unprocessed food: Make meals with vegetables, beans, whole grains, fruit, and lean protein like fish, eggs, and chicken.
Think about alcohol again: If you have fatty liver, doctors often tell you to cut back a lot or stop drinking altogether.
Less sugar and white flour: White bread, sweets, pastries, and soft drinks all make the liver store fat.
A balanced plate should have half of the food as vegetables, a quarter as lean protein, and a quarter as whole grain carbs.
Brisk walking, biking, swimming, and strength training help the body use stored fat as fuel.
Make sleep a priority: Sleep that is short or broken messes with hormones that control weight, appetite, and blood sugar.
Take care of related issues: Checking your blood sugar, cholesterol, and blood pressure on a regular basis can help keep your liver healthy.
Be careful with supplements and medications. Some herbal products and over-the-counter painkillers can be bad for the liver if you take too much of them.
Stay on top of medical follow-up: Tests that are done again show if changes in lifestyle are really helping the liver.
How a typical patient journey might go
A lot of people find out they have fatty liver after a “routine check” at work or a health MOT. For example, a 45-year-old office worker might go to a regular blood test and find out that their liver enzymes are a little high.
An ultrasound then shows that there is fat in the liver. The patient may feel generally well, except for persistent fatigue and an expanding waistline. Instead of giving the patient a bunch of drugs right away, the doctor will usually focus on losing weight, eating better, moving more, and drinking less alcohol.
With regular changes over three to six months, repeat tests often show lower liver enzymes and a clearer ultrasound image. For some people, this is the wake-up call that stops them from getting cirrhosis years later.
Important words that patients often get wrong
When it comes to liver disease, medical language can be hard to understand. There are two words that come up a lot:
Steatosis is the medical term for fat that is stored in the liver. It means the “fatty” stage, which comes before scarring.
Fibrosis means that liver tissue has scarred. The liver gets closer to cirrhosis and losing function as more fibrosis builds up.
Some people think they will feel really sick when damage starts. That assumption can be wrong when you have fatty liver. The organ usually doesn’t make any noise until the disease has gotten worse, which is why those six subtle signs and regular tests are so important.
