What is fatty liver? Fatty Liver should be viewed as a condition with a spectrum of manifestation, arising from accumulation of fat in the liver. It ranges from the simple accumulation of fat in the liver, to fatty accumulation associated with inflammation in the liver and to fatty liver associated with scarring or hardening of the liver (or cirrhosis). What causes fatty liver? The liver is the largest organ of the body and performed a myriad of functions, one of which is in the metabolism or breakdown of fat. The liver will store an abnormal amount of fat if this machinery of fat metabolism is overwhelmed by too much influx of fat into the liver or if the processes of fat breakdown become faulty. Alcohol is the commonest among all the drugs and chemicals that can cause fatty liver. Hence, fatty liver is frequently seen among people who consume alcohol regularly or excessively. Other common association with fatty liver includes diabetes, high triglyceride (the other major component of fat besides cholesterol) level in the blood and obesity. How to recognize that a person has fatty liver? There is usually no symptom among people who have fatty liver. It is often an incidental finding discovered during an ultrasonic scan of the abdomen. This may or may not be associated with abnormal blood test results, usually in the form of a rise in the level of liver enzymes. As the level of fat accumulation in the liver increases, the liver may become enlarged. Other symptoms such as abdominal discomfort may occur. Sometimes, to confirm the diagnosis of fatty liver, doctors may recommend liver biopsy. This can help to confirm the diagnosis and assess the degree of damage in the liver. Does fatty liver have any important impact on our health? Although fatty liver is considered to be relatively harmless to the overall general health in most people, liver scarring (or cirrhosis) occurs in about 20 % of those with fatty liver. This usually occurs among those who have inflammation accompanying the fatty infiltration in the liver. When cirrhosis sets in, the patient can eventually go into liver failure, and may even require liver transplantation. How to treat fatty liver? Treatment of fatty liver should be targeted at its cause. For alcohol - related fatty liver, stopping alcohol intake is the most important step in the whole management plan. For fatty liver associated with diabetes, high triglyceride level and obesity, diet and lifestyle modification is crucial, and when necessary, appropriate medication to be instituted. Fatty liver is usually reversible if recognized and treated early. People with fatty liver should seek consultation and find out the cause of their condition in order to formulate a specific management plan appropriate for a particular individual.