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Health condition

Liver problems, from fatty liver to cirrhosis - explained plainly.

Most liver problems are silent at first and often show up as an abnormal blood test. This guide covers the common causes, the symptoms worth acting on, and when to ask for further tests.

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A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Why trust this guide

  • 01

    Editorial team

    Written by our editorial team from the UK sources listed on each page.

  • 02

    Sourced from guidance

    Checked against NICE, BASL and British Liver Trust sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK hepatology practice, including MASLD terminology and fibrosis-first screening.

Key facts

Liver problems at a glance.

The essentials, in plain English - what "liver problems" covers, why it's often silent, and what your blood tests might mean.

  • What "liver problems" covers

    An umbrella term for fatty liver, viral hepatitis, alcohol-related damage, gallstone complications, cysts, benign lesions, cirrhosis and liver cancer.

  • Most common cause

    Fatty liver disease (MASLD, formerly NAFLD) linked to obesity, type 2 diabetes and metabolic syndrome - now the leading liver problem in the UK.

  • Often silent

    Early liver damage rarely causes symptoms - many people first find out from an abnormal blood test done for another reason.

  • Blood tests

    Liver function tests (LFTs) - ALT, AST, ALP, GGT, bilirubin and albumin - flag inflammation or reduced function, but don't diagnose the cause alone.

  • Reversible, often

    Fatty liver and early alcohol-related damage can improve substantially with weight loss, alcohol reduction and treating diabetes.

  • When it's not silent

    Jaundice, itching, swelling (ascites) or confusion usually mean more advanced disease and need prompt assessment.

Why this guide matters

One hub, several conditions, a clear next step.

"Liver problems" isn't one diagnosis - it's a family of conditions with overlapping symptoms. The three points below shape everything else on this page.

  • Fatty liver is now the most common cause

    Linked closely to obesity and type 2 diabetes, MASLD (formerly NAFLD) drives most new liver problems seen in UK primary care.

  • Symptoms usually arrive late

    The liver has huge reserve capacity, so damage often builds silently until a blood test or scan picks it up.

  • Related pages carry the clinical depth

    For the fuller picture, see our dedicated guides on liver disease and hepatobiliary disease, which this page links to throughout.

Looking for the fuller clinical picture?

This page is a plain-English overview. For a deeper look at chronic liver conditions, read our liver disease guide, and for conditions affecting the liver, bile ducts and gallbladder together, see hepatobiliary disease.

How the diagnosis is made

From an abnormal blood test to a clear answer.

The steps a UK GP or hepatologist will normally follow, in order - so you know what to expect and why.

  1. 01

    Assessing

    History and risk-factor review

    Alcohol intake, weight, diabetes, medication, family history and any prior liver test results.

  2. 02

    Assessing

    Examination

    Checking for an enlarged liver or spleen, jaundice, spider naevi, swelling and signs of fluid (ascites).

  3. 03

    Assessing

    Liver function tests

    ALT, AST, ALP, GGT, bilirubin and albumin - a pattern that points towards the likely cause and severity.

  4. 04

    Confirming

    Viral hepatitis screen

    Hepatitis B and C blood tests where risk factors or unexplained abnormal LFTs are present.

  5. 05

    Confirming

    Ultrasound of the liver

    Looks for fatty change, gallstones, cysts, lesions and structural changes suggesting cirrhosis.

  6. 06

    Confirming

    Fibrosis scoring

    A fibrosis blood score (FIB-4) or Fibroscan estimates scarring without a biopsy in most cases.

  7. 07

    Next steps

    Specialist hepatology referral

    Persistent abnormal results, suspected cirrhosis, or an uncertain diagnosis warrant a hepatologist's opinion.

  8. 08

    Next steps

    Further imaging or biopsy

    MRI, CT or occasionally liver biopsy where a lesion, cancer or unclear diagnosis needs closer characterisation.

Typical timeline: an abnormal blood test to a working diagnosis in two to six weeks.

Common liver problems and symptoms

The conditions behind the umbrella term.

Fatigue, jaundice, abdominal pain, itching, swelling and confusion are the symptoms patients most often search for. Here's what usually causes them.

  • Fatty liver (MASLD/MASH)

    Fat build-up in liver cells, linked to obesity and diabetes - can progress to inflammation (MASH) and scarring if untreated.

  • Viral hepatitis

    Hepatitis B and C cause chronic inflammation - often silent for years before liver damage is picked up.

  • Alcohol-related liver damage

    Ranges from reversible fatty change to alcoholic hepatitis and cirrhosis, depending on intake and duration.

  • Gallstones affecting the liver

    A stone blocking the bile duct can back up bile into the liver, raising LFTs and causing jaundice.

  • Liver cysts

    Usually simple, fluid-filled and harmless - found incidentally on scans. See our dedicated guide on liver cysts.

  • Liver lesions (e.g. haemangioma)

    Benign blood-vessel growths are the most common liver lesion - see our guide on liver haemangioma for detail.

  • Cirrhosis

    Long-standing scarring that replaces healthy liver tissue - the end stage of many chronic liver conditions.

  • Liver cancer

    Primary liver cancer usually develops on a background of cirrhosis - see our dedicated guide on liver cancer.

Symptoms patients search for

Fatigue, jaundice (yellowing of skin or eyes), abdominal pain under the right ribs, persistent itching, swelling of the abdomen or legs (ascites), and confusion in more advanced disease.

Understanding your liver function tests

ALT and AST reflect liver cell inflammation. ALP and GGT point more towards bile-duct or obstructive problems. Bilirubin and albumin reflect how well the liver is working. One abnormal result is common and often not serious - a pattern of persistently abnormal results is what prompts further tests.

Treatment

How liver problems are treated in the UK.

Lifestyle change first for fatty liver and alcohol-related damage, targeted medical treatment for viral hepatitis and gallstones, and specialist care for cirrhosis or cancer.

  • Weight loss and diet

    A 7 to 10% reduction in body weight can significantly improve or reverse fatty liver disease and early fibrosis.

  • Alcohol reduction or abstinence

    The single most effective step for alcohol-related liver damage - improvement can be seen within weeks of stopping.

  • Diabetes and lipid control

    Tight glycaemic and cholesterol control reduces the metabolic drivers behind fatty liver disease and its progression.

  • Antiviral therapy

    Direct-acting antivirals cure most hepatitis C, and antivirals suppress hepatitis B - both greatly reduce long-term liver damage.

  • Hepatitis vaccination

    Hepatitis A and B vaccines prevent infection in at-risk groups, travellers and household contacts of carriers.

  • Gallstone treatment

    Endoscopic removal of a blocked bile duct stone (ERCP), sometimes followed by gallbladder removal, resolves obstructive symptoms.

  • Fibroscan monitoring

    Non-invasive elastography tracks liver stiffness over time, guiding when treatment is working or needs escalating.

  • Liver transplant

    Reserved for decompensated cirrhosis or early liver cancer meeting transplant criteria - a definitive option in specialist centres.

A note on the MDT approach

More complex liver problems benefit from a multidisciplinary team - hepatologists, radiologists, dietitians and, where relevant, surgeons - working from the same imaging and blood results. The British Liver Trust is a valuable independent resource for patients navigating a new liver diagnosis.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and specialist society standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP or hepatologist knows your history and results and can tell you which parts apply to you. If in doubt, get seen.

  • NICE. Non-alcoholic fatty liver disease (NAFLD): assessment and management (NG49).

  • British Association for the Study of the Liver (BASL). Clinical guidance on chronic liver disease.

  • British Liver Trust. Patient information on liver conditions and liver function tests.

  • NHS England. Hepatitis B and C screening and treatment pathways.

Red flags

When a liver problem needs urgent attention.

Most liver problems are manageable in primary care. These are the situations that aren't - and where urgent or same-day assessment is needed.

  • Jaundice

    Yellowing of the skin or eyes signals a build-up of bilirubin and needs prompt medical assessment.

  • Confusion or drowsiness

    Hepatic encephalopathy - toxins the liver can no longer clear affecting the brain - is a medical emergency.

  • Swollen abdomen (ascites)

    New or worsening fluid swelling in the abdomen suggests decompensated liver disease and needs urgent review.

  • Vomiting blood or black stools

    Can indicate bleeding from swollen veins (varices) in advanced liver disease - this is a 999 emergency.

  • Persistent, unexplained itching

    Widespread itching without a rash can reflect bile-acid build-up and warrants liver blood tests.

  • Unintentional weight loss

    Alongside abdominal pain or a mass, this raises concern for liver cancer and needs prompt investigation.

  • Very high or rapidly rising LFTs

    A sharp rise, especially with jaundice, suggests acute liver injury and needs same-day assessment.

  • Known cirrhosis with new symptoms

    Any new confusion, swelling, fever or bleeding in someone with cirrhosis should be treated as urgent.

Living with it

Often reversible, with the right habits.

Four things that make the biggest difference day to day - moderating alcohol, reaching a healthy weight, eating well and staying vaccinated.

A quiet reminder

Early liver damage is often the most reversible.

The sooner fatty liver or alcohol-related damage is picked up, the better the chance of turning it around with lifestyle change alone.

  1. 01 Alcohol

    Keep within safe limits

    No more than 14 units a week, spread over several days, with regular alcohol-free days.

  2. 02 Weight

    Aim for a healthy weight

    Gradual, sustained weight loss is the single most effective step for fatty liver disease.

  3. 03 Diet

    Eat a balanced, Mediterranean-style diet

    Less processed food and added sugar, more vegetables, fibre and healthy fats supports liver health.

  4. 04 Vaccinate

    Stay up to date with hepatitis vaccination

    Especially important if you travel to higher-risk areas or have another chronic liver condition.

Frequently asked

Everything we get asked about liver problems.

Quick answers on symptoms, blood tests, fatty liver and when it's time to see someone.

  • What counts as a "liver problem"?

    It is a broad term covering fatty liver disease, viral hepatitis, alcohol-related damage, gallstone complications, cysts, benign lesions, cirrhosis and liver cancer. This guide gives an overview and points you to detailed guides on liver disease and hepatobiliary disease for the fuller clinical picture.

  • What are the early symptoms of a liver problem?

    Early liver damage is often silent. When symptoms appear, they can include fatigue, mild abdominal discomfort under the right ribs, and itching. More advanced disease can cause jaundice, swelling (ascites) and confusion.

  • What do abnormal liver function tests mean?

    Raised ALT and AST usually suggest liver cell inflammation, while raised ALP and GGT point more towards bile-duct or obstructive causes. A single abnormal result is common and often resolves - persistently abnormal results need further investigation to find the cause.

  • Can fatty liver disease be reversed?

    Yes, in many cases. Losing 7 to 10% of body weight, reducing alcohol, and improving control of diabetes and cholesterol can significantly improve or even reverse fatty liver disease, especially before scarring develops.

  • When should I see a doctor about my liver?

    See a doctor for persistent fatigue, abdominal pain, jaundice, itching or swelling, or if a blood test has shown abnormal liver results. Risk factors such as heavy alcohol use, obesity, diabetes or a family history of liver disease are also good reasons to get checked.

  • What is the difference between liver disease and liver cancer?

    Liver disease is the umbrella term for conditions affecting liver structure or function, including cirrhosis. Liver cancer is a specific diagnosis that most often develops on a background of long-standing liver disease or cirrhosis - see our dedicated liver cancer guide for detail.

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