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Fatty Liver Disease Can Become Serious Without Warning

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Impact of first and further decompensation in patients with compensated ACLD due to MASLD.DOI 10.1016j.jhep.2025.06.014

Fatty liver disease linked to metabolic problems (MASLD) can quietly damage the liver over time. At first, people may feel fine. This stage is called compensated advanced liver disease. But this can suddenly change. When the liver starts to fail, it’s called decompensation. That’s when serious symptoms appear.

A large study looked at over 6,000 people with advanced fatty liver disease. It showed that if the liver decompensates, the risk of dying from liver problems becomes almost 19 times higher. This means that once symptoms begin, the disease becomes much more dangerous.

The first signs of decompensation often include fluid buildup in the belly, called ascites. Bleeding from veins in the throat or stomach can also happen. After the first event, the liver is more likely to get worse again. Nearly 1 in 2 people who had a first episode experienced more problems within five years.

People with liver cancer are at even greater risk. This cancer increases the chance of dying from liver disease even more.

This study sends a clear message. If you have advanced fatty liver disease, talk to your doctor regularly—even if you feel fine. Catching liver problems early can help save your life.

Staying at a healthy weight, managing blood sugar, and avoiding alcohol can all help protect your liver. Regular checkups and liver scans may also help spot early signs before things get worse.

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Dr. Harsh J Shah

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Dr Harsh Shah - GI & HPB Oncosurgeon in India
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