Liver is an important organ of the human body which has a very important role in digestion, synthesis of
various proteins and detoxification of many harmful metabolites. It produces bile which is important
for fat metabolism. It also produces clotting factors which help in wound healing, various hormones
and growth factors. There is only a single liver in the human body and any chronic damage to the liver is
mostly irreparable. Liver transplant is the only option in advanced liver diseases. So it is important to
protect oneself from liver diseases and seek medical attention early.
Fatty liver is a condition in which there is excess deposition of fat in the liver. This affects nearly 10 –
30 % of individuals in the world depending on their country of origin, being more prevalent in
western countries. Its prevalence has been on the rise in India as well over the years with the increasing
incidence of obesity and diabetes mellitus with sedentary lifestyle and improper dietary habit.
Various studies have shown the prevalence of upto 30 % with a higher incidence in urban population as
compared to rural India.
Fatty liver is mainly of two types – alcoholic fatty liver which develops in nearly 90% of heavy
drinkers and another is non-alcoholic fatty liver disease (NAFLD) which is seen in obese and
diabetics. NAFLD again can be simple fatty liver which is a milder form of disease or steatohepatitis
which is an advanced disease and can lead to liver failure or liver cancer in future. Sometimes fatty liver
can also be secondary to drugs, metabolic diseases or nutritional factors.
Initially, patients with fatty liver are asymptomatic. Later they develop tiredness, pain in the right side of
the upper abdomen. As the disease progresses, it can lead to jaundice, blood vomiting, abdominal
distention and liver cancer.
As most of the patients are asymptomatic, it is diagnosed incidentally on routine blood tests or
abdominal sonography done for other indication. Routine liver function tests will show abnormal
results. Abnormal liver tests should also be assessed carefully and other causes of liver disease like
viral hepatitis should not be missed. Ultrasonography will easily diagnose fatty liver where the liver
appears bright and more echogenic. Fibroscan is a non-invasive marker for chronic liver damage.
Sometimes a liver biopsy is required, where a small piece of liver is removed through the needle and
checked under a microscope to assess the degree of damage or to rule out other causes of liver
Treatment should focus on stopping alcohol consumption and weight loss should be emphasized via
a combination of diet control and exercise, especially in non-alcoholic fatty liver disease. Control of
underlying diabetes, hypertension and high cholesterol level is very important. Diet should include
low fat, avoidance of sweets and intake of high fibres which includes fruits and vegetables. Exercise
has to be done regularly in the form of brisk walking, running, jogging, swimming or outdoor sports.
Disease is reversible if intervened early. Proper medical advice should be sought upon early so that
further progression of disease can be prevented.