Ask the Expert: Understanding Fatty Liver and Preventing Cirrhosis

Fatty liver, also known as steatotic liver disease, occurs when fat builds up in the liver and can cause chronic inflammation. If left untreated, it may lead to scarring (fibrosis) and eventually cirrhosis, a serious and potentially life-threatening condition. It affects about 1 in 3 people and is the leading reason for liver transplant in women and adults over 65. Despite its high prevalence, fatty liver disease often remains underdiagnosed, as many individuals do not experience noticeable symptoms. Risk factors include obesity, prediabetes, type 2 diabetes, high cholesterol, and high blood pressure.

What Are the Symptoms?

While most people don’t experience symptoms, some may feel fatigue or discomfort in the upper right abdomen. Fatty liver is often discovered during routine lab work or imaging tests showing abnormal liver enzymes or fat in the liver.

Who Should Be Screened?

Patients with high risk factors for fatty liver or with fatty liver detected on imaging should be screened using a simple lab-based risk score called the FIB-4 index. If results are normal, the test should be repeated every 1–2 years.

If the initial screening test results are abnormal, you can undergo one of many non-invasive tests to assess for the degree of fat deposits in the liver, as well as to evaluate if there already is presence of fibrosis, that may be corrected to prevent the development of cirrhosis. Available non-invasive testing can be done via imaging studies (Vibration-Controlled Transient Elastography) or blood tests. If advanced fibrosis is identified, you may need a referral for evaluation by a liver specialist or gastroenterologist.

How do you Treat and Prevent the Development of Cirrhosis?

The main treatment is lifestyle changes: regular exercise, a healthy diet (especially the Mediterranean diet), and aiming for a 10% weight loss. This can reduce fat in the liver, ease inflammation, and potentially reverse early scarring.

As of March last year, the first FDA-approved medication was made available for patients with advanced fibrosis but without cirrhosis. Some diabetes and weight-loss medications may also benefit the liver. In certain cases, weight-loss surgery may be an option.

Important Reminder

It is important to note that patients with fatty liver should completely abstain from the use of alcohol, as it may worsen liver disease and its progression to cirrhosis.

About Dr. Sarahi Herrera Gonzalez

Herrera Gonzalez is the only female Gastroenterologist at the DHR Health Gastroenterology Institute. She is dedicated to educating patients on ways to reduce their risk of developing serious conditions, such as colorectal cancer.

Dr. Sarahi Herrera Gonzalez, DHR Health Gastroenterologist
5520 Leonardo Da Vinci Dr. Suite 100 Edinburg, TX 78539
To schedule an appointment, call (956) 362-3636
To learn more about gastroenterology services at DHR Health, https://dhrhealth.com/services/gastroenterology-advanced-endoscopy/

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