Fatty Liver Disease Often Has No Symptoms — Is Your Liver Healthy?

Do you experience abdominal bloating, discomfort in the upper right side of your abdomen, unexplained fatigue, or abnormal liver blood tests?

These symptoms may sometimes be associated with fatty liver disease, a common condition in which excess fat accumulates in the liver.

Many people with fatty liver disease have no symptoms at all. The condition is often discovered during routine blood testing or an abdominal ultrasound performed for another reason.

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At 14 Street Medical Arts in New York City, our physicians evaluate patients with suspected fatty liver disease and provide convenient access to abdominal ultrasound, laboratory testing, and additional diagnostic imaging when medically appropriate.

An abdominal ultrasound is a non-invasive examination that can help identify signs of fat accumulation in the liver and other abnormalities of the abdominal organs.

What Is Fatty Liver Disease?

Fatty liver disease occurs when excess fat builds up inside liver cells.

The condition is increasingly common, particularly among people with obesity, diabetes, high cholesterol, or other metabolic risk factors.

The newer medical terminology for fatty liver associated with metabolic dysfunction is Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).

MASLD was previously called nonalcoholic fatty liver disease, or NAFLD.

Some patients develop a more serious form called Metabolic Dysfunction-Associated Steatohepatitis (MASH), previously known as NASH.

MASH involves liver inflammation and injury and can lead to liver scarring over time.

Not everyone with fatty liver develops serious liver disease, but identifying patients at risk for progression is important.

What Are the Symptoms of Fatty Liver?

One of the biggest challenges with fatty liver disease is that it frequently causes no noticeable symptoms.

When symptoms occur, they may include:

• Fatigue

• Discomfort in the upper right abdomen

• A feeling of fullness in the abdomen

• General abdominal discomfort

Bloating, nausea, and weight changes may occur alongside fatty liver disease, but they are nonspecific and can have many other causes.

Some patients discover fatty liver only after an ultrasound shows increased liver echogenicity, a finding that may suggest fat accumulation.

Who Is at Risk for Fatty Liver Disease?

Fatty liver is especially common among people with certain metabolic conditions.

Risk factors include:

• Being overweight or obese

• Type 2 diabetes

• Prediabetes

• High cholesterol

• Elevated triglycerides

• High blood pressure

• Insulin resistance

• Metabolic syndrome

• Sedentary lifestyle

• Certain medications

• Family history of metabolic or liver disease

Fatty liver can also occur in people who are not overweight.

Alcohol consumption may contribute to liver fat accumulation and liver injury, so your physician will review your alcohol intake as part of the evaluation.

Why Is Fatty Liver Important?

The liver performs hundreds of essential functions, including processing nutrients, producing important proteins, and helping the body metabolize medications and other substances.

In some patients, fatty liver remains relatively stable.

In others, ongoing inflammation and injury can lead to progressive liver scarring.

Potential complications include:

• Liver inflammation

• Liver fibrosis

• Cirrhosis

• Liver failure in advanced cases

• Increased risk of liver cancer, particularly in patients with advanced liver disease

Fatty liver is also associated with increased cardiovascular risk.

That is why a diagnosis of fatty liver should lead to an assessment of both liver health and metabolic risk factors.

Abdominal Ultrasound for Fatty Liver Disease

What Is an Abdominal Ultrasound?

An abdominal ultrasound is a non-invasive diagnostic imaging examination that uses sound waves to produce images of organs inside the abdomen.

It does not use ionizing radiation.

During the examination, an ultrasound technologist places a small handheld device called a transducer against the abdomen.

The transducer sends sound waves into the body and receives returning echoes, which are processed into images.

Abdominal ultrasound can help physicians evaluate the liver and several other abdominal organs.

Can an Ultrasound Detect Fatty Liver?

Yes. A conventional abdominal ultrasound can identify imaging findings suggestive of fatty liver, particularly when fat accumulation is moderate or substantial.

A fatty liver may appear brighter than normal on ultrasound images.

However, ultrasound has important limitations:

• Mild fatty liver may not be detected.

• A normal ultrasound does not completely exclude liver fat accumulation.

• Conventional ultrasound cannot reliably determine the degree of liver inflammation.

• Ultrasound alone cannot accurately stage liver fibrosis.

Additional blood tests, fibrosis assessment, or specialized imaging may be necessary.

What Can an Abdominal Ultrasound Show?

An abdominal ultrasound may help evaluate:

• Liver size and appearance

• Findings suggestive of fatty infiltration

• Certain liver lesions

• Gallstones

• Gallbladder abnormalities

• Bile duct dilation

• Certain kidney abnormalities

• Other abdominal findings

Ultrasound can provide useful information when a patient has abnormal liver enzymes or unexplained upper abdominal symptoms.

Is an Abdominal Ultrasound Painful?

No. Abdominal ultrasound is generally painless.

The examination is performed using a transducer and gel applied to the skin.

Patients may experience mild pressure as the technologist moves the transducer over the abdomen.

The test does not involve injections or radiation.

How Should I Prepare for an Abdominal Ultrasound?

Depending on the examination being performed, patients may be instructed to avoid eating or drinking for several hours beforehand.

Preparation requirements vary according to the organs being evaluated.

Follow the instructions provided by Radiology MedicalArts when scheduling your ultrasound.

Fatty Liver and Abnormal Liver Blood Tests

Fatty liver is sometimes discovered after routine blood tests show elevated liver enzymes.

Commonly evaluated tests include:

• ALT (alanine aminotransferase)

• AST (aspartate aminotransferase)

• Alkaline phosphatase

• Bilirubin

• Albumin

• Platelet count

Your physician may also evaluate blood sugar, hemoglobin A1c, cholesterol, and triglycerides.

Normal liver enzymes do not completely rule out fatty liver or advanced liver scarring.

When fatty liver is suspected or identified, physicians may use blood-test-based tools such as FIB-4 to assess the likelihood of advanced fibrosis.

Some patients may require elastography, a specialized test that helps estimate liver stiffness.

Fatty Liver and Diabetes

Fatty liver disease is strongly associated with insulin resistance and type 2 diabetes.

Patients with diabetes may have a greater risk of progressive liver disease, particularly when other metabolic risk factors are present.

If you have diabetes, high cholesterol, high blood pressure, or obesity, your physician may recommend evaluating your metabolic and liver health.

Fatty Liver and High Cholesterol

Fatty liver frequently occurs alongside abnormal cholesterol and triglyceride levels.

These conditions may share underlying metabolic risk factors.

Addressing cholesterol, blood pressure, blood sugar, weight, and physical activity is important for overall cardiovascular and liver health.

Can Fatty Liver Be Reversed?

In many patients, liver fat can decrease with appropriate lifestyle changes and treatment of contributing conditions.

Strategies may include:

• Gradual weight reduction when appropriate

• Regular physical activity

• Improving dietary habits

• Managing diabetes

• Controlling cholesterol

• Managing blood pressure

• Reducing or avoiding alcohol

• Reviewing medications with a healthcare provider

• Following up on liver tests and fibrosis risk

Patients should not start medications or supplements marketed as liver cleanses without discussing them with a physician.

For some patients with more advanced disease, additional specialist-directed treatment may be appropriate.

What Foods Should You Avoid With Fatty Liver?

Dietary recommendations should be individualized, but patients are commonly advised to reduce:

• Sugar-sweetened beverages

• Excessive refined carbohydrates

• Highly processed foods

• Excess calories

• Foods high in saturated fat

• Alcohol

A Mediterranean-style dietary pattern, including vegetables, fruit, whole grains, legumes, nuts, and unsaturated fats, may be beneficial.

When Is Additional Imaging Necessary?

Ultrasound may be an appropriate first imaging examination for certain abdominal symptoms or abnormal liver tests.

However, some patients require additional evaluation.

Depending on the findings, a physician may recommend:

Liver Elastography

A specialized non-invasive examination that helps estimate liver stiffness and assess possible fibrosis.

CT Scan of the Abdomen

CT may be useful when evaluating certain abdominal abnormalities, although it is not routinely needed to diagnose uncomplicated fatty liver.

MRI of the Abdomen

MRI can provide detailed information about liver structures and, with specialized techniques, can quantify liver fat.

The appropriate test depends on the patient's medical history, symptoms, laboratory findings, and clinical needs.

Why Choose 14 Street Medical Arts for Fatty Liver Evaluation?

At 14 Street Medical Arts, patients have access to comprehensive medical services for liver and metabolic health.

Our services include:

• Primary care

• Gastroenterology

• Abdominal Ultrasound

• Laboratory testing

• Diabetes evaluation

• Cholesterol management

• CT imaging

• MRI imaging

• Preventive medical examinations

• Coordinated specialty referrals when appropriate

Our physicians can review your symptoms and risk factors and determine which tests may be helpful.

Convenient Abdominal Ultrasound in Manhattan

Radiology MedicalArts

500 East 14th Street
New York, NY 10009

Additional 14 Street Medical Arts locations:

East 14 Street MedicalArts
332 East 14th Street
New York, NY 10003

West 14 Street MedicalArts
110 West 14th Street
New York, NY 10011

Columbus Ave MedicalArts
912 Columbus Avenue
New York, NY 10025

We serve patients throughout Union Square, East Village, Gramercy Park, Chelsea, Greenwich Village, Flatiron District, Upper West Side, and surrounding New York City neighborhoods.

Frequently Asked Questions About Fatty Liver and Ultrasound

Can an abdominal ultrasound detect fatty liver?

Yes. Ultrasound can identify findings suggestive of moderate or substantial fat accumulation in the liver. However, mild fatty liver may not be visible.

Can fatty liver cause abdominal pain?

Fatty liver is often asymptomatic, but some patients experience discomfort in the upper right abdomen. Persistent abdominal pain should be evaluated because many other conditions can cause similar symptoms.

Can fatty liver cause bloating?

Bloating is not a specific symptom of fatty liver. It may occur because of unrelated gastrointestinal conditions or other abdominal problems.

Is fatty liver dangerous?

Fatty liver does not always progress. However, some patients develop liver inflammation, fibrosis, or cirrhosis. Evaluating fibrosis risk is important.

Do I need an ultrasound if my liver enzymes are high?

Your physician may recommend abdominal ultrasound or other tests depending on your laboratory results, risk factors, and medical history.

Can I have fatty liver with normal blood tests?

Yes. Some patients with fatty liver, including those with significant fibrosis, have normal liver enzyme levels.

Can fatty liver go away?

Liver fat may decrease with sustained lifestyle changes and management of metabolic risk factors. More advanced liver scarring may require additional treatment and monitoring.

How often should I repeat my liver ultrasound?

There is no universal repeat-ultrasound schedule for uncomplicated fatty liver. Your physician will determine whether follow-up imaging, laboratory testing, or fibrosis assessment is needed.

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Schedule an Abdominal Ultrasound in NYC

If you have abnormal liver blood tests, suspected fatty liver, upper abdominal discomfort, diabetes, high cholesterol, or other risk factors for liver disease, consider scheduling a medical evaluation.

At 14 Street Medical Arts, our physicians can assess your liver health and determine whether an abdominal ultrasound or additional testing is appropriate.

Concerned About Fatty Liver? Get Your Liver Evaluated.

Contact Radiology MedicalArts at 500 East 14th Street, Manhattan, to learn more about abdominal ultrasound services and scheduling.

About 14 Street Medical Arts

14 Street Medical Arts is a multi-specialty medical practice serving patients throughout New York City. Our services include Primary Care, Gastroenterology, Neurology, Cardiology, Pulmonology, Sleep Medicine, laboratory testing, abdominal ultrasound, MRI, CT, and comprehensive diagnostic imaging.

Our goal is to provide convenient, coordinated medical care and help patients identify important health concerns early.