Fatty liver disease symptoms: The colour of your pee can be a serious warning sign


Non-alcoholic fatty liver disease (NAFLD) is the build-up of extra fat in liver cells that is not caused by alcohol. The condition progresses through a number stages, the latter of which can be life-threatening. Unfortunately, most people with mild NAFLD are unlikely to notice any symptoms that can alert them to the condition.

“For those who go on to develop NASH, Fibrosis and Cirrhosis it may be many years before symptoms develop,” explains the British Liver Trust (BLT).

Non-alcohol related steatohepatitis (NASH) is a more serious form of NAFLD, whereby the liver has become inflamed and fibrosis is where persistent inflammation causes scar tissue around the liver and nearby blood vessels, but the liver is still able to function normally.

According to the BLT, dark urine is a telltale sign NAFLD has progressed to these later stages.

Other serious signs include:

  • Yellowness of the eyes and skin (jaundice)
  • Bruising easily
  • Swelling of the lower tummy area (ascites)
  • Vomiting blood (haematemesis)
  • Dark black tarry faeces (melena)
  • Periods of confusion or poor memory (encephalopathy)
  • Itching skin (pruritus).

READ MORE: Non-alcoholic fatty liver disease: Condition may cause enlarged liver – two signs to spot

Fortunately, you can stop NAFLD progression by making healthy lifestyle interventions.

If you have NAFLD, you should aim to eat a healthy, balanced diet.

According to Bupa, this means:

  • Choose whole grain carbohydrates (such as breads, rice and pasta) which are high in fibre
  • Avoid food and drinks that are high in sugar
  • Eat more vegetables and fruit
  • Eat less saturated fat. Replace saturated fats with monounsaturated fats or polyunsaturated fats, especially omega-3 fatty acids. This may help reduce your risk of heart disease which can be linked to NAFLD
  • Monitor your portion sizes, especially if you’re trying to lose weight.

Engaging in regular physical activity can help you to lose excess weight but it can also bring direct benefits for managing NAFLD.

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As Bupa explains, exercise may also help to reduce damage to your liver even if you don’t successfully lose any weight.

How is NAFLD diagnosed?

The NHS explains: “NAFLD is often diagnosed after a blood test called a liver function test produces an abnormal result and other liver conditions, such as hepatitis, are ruled out.”

But blood tests do not always pick up NAFLD.

“The condition may also be spotted during an ultrasound scan of your tummy,” explains the NHS.

NAFLD and NASH are both linked to the following:

  • Overweight or obesity
  • Insulin resistance, in which your cells don’t take up sugar in response to the hormone insulin
  • High blood sugar (hyperglycaemia), indicating prediabetes or type 2 diabetes
  • High levels of fats, particularly triglycerides, in the blood.

“These combined health problems appear to promote the deposit of fat in the liver,” explains the Mayo Clinic.

“For some people, this excess fat acts as a toxin to liver cells, causing liver inflammation and NASH, which may lead to a buildup of scar tissue in the liver.”

A wide range of diseases and conditions can also increase your risk of NAFLD, including:

  • High cholesterol
  • High levels of triglycerides in the blood
  • Metabolic syndrome
  • Obesity, particularly when fat is concentrated in the abdomen.



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