Nonalcoholic fatty liver disease often has no early symptoms in children or adults, but a fat belly is one signal. And diabetes, high cholesterol, high triglycerides or heart problems often accompany the disease.

As fatty liver disease worsens, these symptoms can appear:

• Chronic fatigue or weakness.
• Abdominal discomfort, such as cramping or nausea.
• Confusion or difficulty thinking.
• Bruising or bleeding easily, including nosebleeds.
• Reduced appetite and weight loss.

Concerned parents can request a blood test for liver enzyme levels. Also, a doctor can check the abdomen to see if the liver is enlarged or order a scan or ultrasound.

Those tests can miss problems, however. The most reliable one is a biopsy, in which a small amount of tissue is removed from the liver and studied under a microscope.

To stop or prevent fatty liver disease, patients should:

• Exercise and eat a balanced diet to lose weight slowly but steadily.
• Control diabetes and cholesterol with medication and diet.
• Get vaccinated against hepatitis to prevent further injury to the liver.
• Avoid alcohol, drugs and supplements that can damage the liver.
• Have a liver specialist oversee your care.
• Avoid raw oysters and shellfish, which can harbor bacteria very dangerous to people with advanced liver disease.

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