Your ultrasound says fatty liver. What now?

Fatty liver is found on most days in our OPD, usually by accident — someone gets an ultrasound for stomach pain or a health check, and the report mentions it. The word 'liver' frightens people. In most cases it should not.

What the grade means

Grade 1, 2 or 3 describes how much fat the ultrasound can see. It is not a measure of damage, and a Grade 3 report does not mean the liver is failing.

What actually matters

The real question is whether scarring (fibrosis) has started. Fat alone can be cleared. Scarring is much harder to reverse. This is checked with:

• Fibroscan — a painless scan that measures liver stiffness
• Blood tests such as SGPT, SGOT and platelet count
• Scores like FIB-4, calculated from those blood numbers

What helps

• Losing 7 to 10% of body weight clears a large part of the fat in most people
• Controlling sugar and triglycerides, if those are high
• Walking or any activity most days — this helps even before the weight moves
• Cutting out alcohol completely
• Cutting down sweet drinks, fruit juice, maida and fried food

What does not help

There is no tablet, syrup or tonic that removes liver fat on its own. Liver tonics sold over the counter do nothing for fibrosis. Medicines are sometimes added for diabetes or cholesterol, but they support the diet change — they do not replace it.

When to get it checked properly

• You also have diabetes or pre-diabetes
• SGPT or SGOT has stayed high for more than three months
• Fibroscan has not been done yet
• There is a family history of liver disease