What Are the Signs & Symptoms of a Fatty Enlarged Liver?

Fatty liver or steatosis is a liver disorder in which extra fat accumulates inside hepatocytes or liver cells, causing damage and disturbing the function of the liver in some cases, as mentioned by the Merck Manual. A fatty, enlarged liver is commonly caused by the excessive use of alcohol, due to unwanted side effects of some medications and the build-up of toxins in the body. It may also be associated with a metabolic syndrome that occurs in obese individuals with insulin resistance, high blood lipid levels and high blood pressure. The American College of Gastroenterology notes that a fatty, enlarged liver is a common condition and typically does not cause many symptoms, but there are a few to watch out for.

Is This an Emergency?

If you are experiencing serious medical symptoms, seek emergency treatment immediately.

Abdominal Fullness

The American College of Gastroenterology notes that a fatty liver may cause an abdominal mass. Some individuals may experience a sensation of abdominal fullness and firmness due to the enlarged mass the fatty liver causes. This is common in obese individuals and patients with high blood cholesterol. In some cases of fatty, enlarged liver the resulting abdominal mass can be felt by a doctor on physical examination.

Skin Discoloration

Individuals with a fatty, enlarged liver may develop thickened skin with dark pigments accumulating over the neck folds, under armpits or sometimes on the palms, as noticed by the University of Maryland Medical Center. This sign is associated with increased lipid levels in the body that causes insulin resistance and endocrine disorders.


Fatigue or tiredness is a common symptom of a fatty, enlarged liver. This may occur because the liver plays a major role in metabolism, energy generation from food and detoxification of harmful substances such as alcohol and drug. When excess fat accumulates in the liver, the healthy liver cells are unable to function adequately. MayoClinic.com notes that this may cause feelings of fatigue because ingested food is not efficiently used to produce and store energy in the liver.

Pain and Discomfort

Some individuals with enlarged fatty liver may feel mild abdominal discomfort in the upper right side of the abdomen below the ribs or in the center of the abdomen. The Cleveland Clinic explains that this occurs because enlarged liver bulges out and pushes against the abdominal wall and adjacent organs as it increases in size. This causes gives a sensation of fullness and may cause pain and discomfort in more severe cases.