1. Take the Liver Disease Quiz
2. Hepatitis Slideshow: A Visual Guide to Hepatitis
3. Take the Alcohol Quiz

Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

View Full Profile

Medical Editor:

Bhupinder Anand, MD

Physical Exam and Medical History

When concern exists for the presence of fatty liver disease, the health care practitioner will try to find the underlying cause and risk factors. Questions may be asked regarding alcohol consumption, medication use (both prescription and over-the-counter) and past medical history, especially concerning previous history of viral hepatitis (the most common are A, B, and C) and immunizations against infectious hepatitis. Screening for diabetes may be appropriate.

Physical examination may reveal an enlarged liver that can be palpated or felt in the abdomen below the right rib margin. Otherwise, it may require the development of cirrhosis to elicit abnormalities on physical examination. These may initially include jaundice or a yellowish tinge to the skin and eyes, muscle wasting, hair thinning, abnormal skin blood vessels called spider angiomata, and splenomegaly (enlarged spleen).

Blood Tests

Blood tests may be helpful as screening tests for liver inflammation, although liver function studies such as serum transaminases (AST, ALT) may be normal or elevated and not necessarily related to the severity of the liver disease. Other liver tests such as alkaline phosphatase and bilirubin are often normal. Serum ferritin (a measure of iron storage) may be abnormal. In patients with NAFLD and NASH, cholesterol levels including triglycerides are often elevated.

Imaging Studies

Ultrasound of the liver can reveal patterns suggestive of fatty infiltration of the liver. Computerized tomography (CT scan) and magnetic resonance imaging (MRI scan) are also useful in the evaluation of fatty liver.

Liver Biopsy

The definitive diagnosis of fatty liver disease can only be confirmed by liver biopsy, where a needle is inserted into the liver through the abdominal wall to obtain a piece of tissue which is analyzed under the microscope.

Must Read Articles Related to Fatty Liver Disease

Alcoholism Alcohol problems vary in severity from mild to life threatening and affect the individual, the person's family, and society in numerous adverse ways. Despite al...learn more >>

Ascites Ascites is an accumulation of fluid in the peritoneal cavity (abdominal cavity). The primary cause of ascites is liver disease such as cirrhosis, acute liver fa...learn more >>

Cholesterol FAQs Test your cholesterol IQ by reading about cholesterol FAQs (cholesterol facts) like the risk factors for high cholesterol (diet, lack of exercise, smoking, here...learn more >>

See the Entire Fatty Liver Disease Topic Guide »