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Fatty Liver Disease

Fatty liver disease is a serious condition that occurs when too much fat builds up within the liver. Hepatologists (liver specialists) classify the disease as either nonalcoholic fatty liver disease or fatty liver disease caused from alcohol abuse. Oftentimes fatty liver disease has no symptoms. But in some individuals, the accumulation of fat causes inflammation — called steatohepatitis — that damages the liver.

Steatohepatitis associated with nonalcoholic fatty liver disease (NASH) is one of the leading causes of cirrhosis of the liver in the United States. Hepatologists at The Liver Center at Virginia Mason, in Seattle, specialize in treating patients with fatty liver disease, offering treatments not available elsewhere within clinical trials. One such study is investigating iron depletion therapy in patients with this disease. For more information or to schedule an appointment with a Virginia Mason gastroenterologist, call (206) 223-2319.

Symptoms of Fatty Liver Disease

Fat that accumulates within liver cells often cause no symptoms until it is beyond 10 percent of the liver's weight and causes steatohepatitis or inflammation.

Symptoms of steatohepatitis can include:

  • Pain in the upper right abdomen
  • Fatigue
  • Weight loss
  • Weakness 

Diagnosing Fatty Liver Disease

In many instances, fatty liver disease is diagnosed incidentally, when blood tests measuring liver enzymes are taken for other reasons. Your hepatologist also may suspect nonalcoholic fatty liver disease if an imaging procedure shows that your liver is enlarged. In addition to blood tests, your hepatologist may perform the following procedures:


You may have an ultrasound, CT scan or MRI (magnetic resonance imaging) that visualizes your liver on a monitor.


This procedure to obtain a small sample of liver tissue will definitely determine if you have fatty liver disease. It is commonly performed by injecting a thin needle through your abdominal skin (percutaneously) and into the liver. The area of the puncture is numbed first with a local anesthetic.

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Treating Fatty Liver Disease

Currently there are no treatments available for fatty liver disease. Your hepatologist will recommend steps to reduce the amount of fat in your liver to prevent further, irreversible damage. Untreated, fatty liver disease can lead to steatohepatitis — inflammation — that can progress further to cirrhosis, which is scarring and hardening of the liver.

Preventive measures for fatty liver disease include:

  • A low calorie diet
  • Strict medical management of diabetes or metabolic syndrome
  • Management of high triglycerides
  • Management of high cholesterol
  • An exercise program
  • Avoidance of alcohol

You also will be monitored regularly to determine if your fatty liver disease is being kept under control.

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