‘I’m a doctor - one of the most common signs of fatty liver disease strikes at random times of the day or after meals’

Katie Nicholl opens up on her battle with liver cancer
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Solen Le Net

By Solen Le Net


Published: 26/06/2025

- 10:22

A gastroenterologist has shared the most common signs he's spotted in his patients throughout his career

Non-alcoholic fatty liver disease (NAFLD) has become a significant burden on public health in the UK, yet despite its widespread prevalence, the condition often goes undetected.

In many cases, it is only discovered incidentally when imaging studies are conducted for unrelated health concerns.


While understanding the disease is a work in progress, doctors have shared pearls of wisdom to help the public recognise the signs.

Gastroenterologist Dr Joseph Salhab listed three common symptoms of the disease that he spotted in his patients throughout his career, naming fatigue and abdominal pain as two major tell-tale signs.

Dr Salhab

NAFLD can produce warning signs in the advanced stages

GETTY / TIKTOK

"I'm a liver doctor," he declared in a recent TikTok clip. "The first is fatigue, probably one of the most commonly reported symptoms in people with fatty livers.

“We think it’s related to metabolic dysfunction of the liver and sleep disturbances that can occur in fatty liver disease."

The second symptom involves discomfort in the body's midsection, with Dr Salhab noting it strikes sporadically throughout the day.

“Pain in the right upper quadrant of your belly [...] can happen in random parts of the day or after you eat, and sometimes this can indicate active inflammation of the liver," he explained.

The most concerning aspect of the disease is its ability to remain hidden, however.

“The most common symptom is absolutely nothing,” Dr Salhab stressed.

“In fact, most people with fatty liver have no signs and no symptoms, and fatty liver is a sneaky disease because 50 per cent of people who have a fatty liver can even have normal lab tests.”

The caution comes as recent data shows more than 15 million people in the US, UK, Germany, and France are unaware they have the most aggressive form of fatty liver disease.

NAFLD

People at risk of developing NAFLD have high blood pressure

GETTY

Individuals at heightened risk of developing NAFLD have high blood pressure, type 2 diabetes and high cholesterol.

That said, the condition can still affect people without any of these risk factors.

According to NHS Inform: "If you're diagnosed with NAFLD, further tests may be needed to determine which stage you have.

"This may involve a special blood test or having another type of ultrasound scan. Some people may also need a small sample of liver tissue taken using a needle to have it analysed in a laboratory."