Complications and Risks of Fatty Liver Disease

Most people with fatty liver do not develop serious liver damage, but a minority do. Early care lowers the risk.

Liver-related complications

• Steatohepatitis (MASH). Fat with inflammation and liver cell injury.
• Fibrosis. Scar tissue forming in the liver.
• Cirrhosis. Advanced scarring that can cause fluid in the abdomen (ascites), swollen veins that may bleed, jaundice, confusion (hepatic encephalopathy) and liver failure.
• Liver cancer (hepatocellular carcinoma). Risk is higher in cirrhosis and occasionally occurs earlier.
• Need for a liver transplant in advanced disease.

Other health risks

• Heart disease and stroke. Often the leading cause of death in people with fatty liver.
• Type 2 diabetes. Fatty liver and diabetes feed each other.
• Chronic kidney disease.
• Some cancers outside the liver.

Who is at higher risk of progression

• People with diabetes or obesity
• Older age
• Ongoing alcohol use
• Raised liver enzymes or abnormal fibrosis scores
• Family history of cirrhosis

Warning signs

• Yellow skin or eyes
• Swelling of the legs or belly
• Black stools or vomiting blood
• Confusion or severe drowsiness
• Persistent itching, easy bruising

Emergency

Vomiting blood, black stools, sudden confusion or severe abdominal pain need urgent care. Call 112 or 102.

Reducing risk

Weight loss, activity, diet, no alcohol, good control of sugar, cholesterol and blood pressure, and regular monitoring all lower complications. Avoid unproven herbal products.