updated 9/7/2008 2:08:11 PM ET 2008-09-07T18:08:11

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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