Two types of pain that signal fatty liver disease as new study finds 'silent killer' is soaring in Britain

Composite image of non-alcoholic fatty liver disease  and stomach pain

A dull or aching pain in the top right of the tummy can spell NAFLD

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Adam Chapman

By Adam Chapman


Published: 12/06/2024

- 13:14
  • One in five young adults show signs of non-alcoholic fatty liver disease
  • Symptoms only begin to show once patients develop complications
  • NAFLD can lead to irreversible liver scarring if left untreated

Two types of tummy pain can signal non-alcoholic fatty liver disease (NAFLD), warns the NHS.

The push to raise awareness of the symptoms comes after new study from Bristol University found one in five young adults show signs of the 'silent killer'.



Fatty liver disease is a condition in which fat builds up in your liver. It is either related to alcohol consumption or obesity and its attendant ills, such as high cholesterol. NAFLD relates to the latter.

It can lead to irreversible liver scarring if left untreated. However, it is difficult to spot because symptoms only begin to show once patients develop complications. Hence the nickname 'silent killer'.

Man holding his stomach

One in five adults show signs of fatty liver, shows a study led by Bristol University

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“Early detection is key, before people develop advanced liver scarring and to help reverse any damage,” said Doctor Kushala Abeysekera, from the Bristol Doctoral College at the University of Bristol.

So, what should you look for?

There are not usually any symptoms of NAFLD in the early stages. You probably will not know you have it unless it's diagnosed during tests carried out for another reason.

However, people with more advanced stages of NAFLD may experience a dull or aching pain in the top right of the tummy (over the lower right side of the ribs), warns the NHS.

Other symptoms include:

  • Extreme tiredness
  • Unexplained weight loss
  • Weakness

How common is it and who is affected?

Being overweight or obese is a major risk factor and the risk generally increases with age.

However, cases of NAFLD are rising among the young at an alarming rate.

Doctor Abeysekera was responsible for a new study which analysed liver scans from the Children of the 90s - one of a few studies in the world investigating liver disease in a younger population and is important in helping to identify and treat those most at risk.

“We think of liver disease as developing in people in their 40-60s. Young adults represent something of a blind spot for doctors – we just didn’t know how much liver disease there is in this age group. Children of the 90s has been vital in discovering how common liver damage is within this younger age group.”

Researchers first looked at people who did not report harmful alcohol consumption and found that one in five had NAFLD.

Stomach pain

Rates of NAFLD are rising among the young, researchers warn

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Then they looked at all participants, and again found that more than 20 percent displayed evidence of fatty liver. One in 40 people were found to have already developed fibrosis or liver scarring. Participants who had fatty liver and reported harmful alcohol use had the greatest risk of liver scarring.

“Without the support of Children of the 90s, we’d be unaware of the scale of this problem in young people in the UK,” said Doctor Abeysekera.

The research has helped doctors to identify people who present with symptoms at an earlier stage, and to understand why they might be affected. Gastroenterologists and hepetologists across the country have been seeing patients present to hospital earlier with the complications of alcohol-related liver disease.

“We know that the main causes of advanced liver disease in the UK are alcohol and obesity. These findings should lead to further public health measures such as minimum unit pricing on alcohol and reduced targeted advertising from fast food chains, for example. Ultimately, by supporting public health initiatives like these, this kind of knowledge can help us to save lives,” said Doctor Abeysekera.

The liver scans have been repeated with the now 30-year-old participants to measure trends in a different age group.

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