How long does it take for fatty liver to turn into cirrhosis?

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According to a 2021 article, in 3–5% of people with NAFLD, the condition may progress to nonalcoholic steatohepatitis (NASH) with cirrhosis.

There is little recent scientific research into how often AFD turns into cirrhosis. However, scientists investigated the effect of AFLD in older research from 2004. The study states that people with AFLD have an 8–30% risk of developing fibrosis or cirrhosis after 10 years of excess alcohol consumption.

It can take several years for a person with fatty liver to develop cirrhosis, depending on the cause.

Scientists consider certain levels of alcohol intake to predict how more severe cases of ALD may progress to cirrhosis. These levels are 40–80 grams (g) of ethanol per day for males and 20–40 g for females. If a person consumes these levels of alcohol daily, their AFLD may progress to cirrhosis in 10–12 years.

People with NAFLD may develop NASH and NAFLD-related cirrhosis over 3–6 years. However, a person’s risk depends on multiple factors, including:

• diabetes
• body mass
• hypertension
• menopause
• genetic factors

Fatty liver is a condition where a person has a buildup of fat in their liver. Excess alcohol intake can cause this fat buildup, leading to a person developing AFLD. NAFLD is a type of fatty liver that is not due to alcohol use.

NASH is a form of NAFLD that causes the liver to have inflammation and damage. NASH may lead to cirrhosis or liver cancer. People may be more likely to develop NAFLD if they have any of the following:

• certain genes
• conditions such as:
  • obesity
  • type 2 diabetes
  • insulin resistance
  • abnormal levels of blood fats
• metabolic syndrome, which typically includes any three of the following:
  • large waist size
  • high blood pressure
  • high levels of blood triglycerides
  • low levels of HDL cholesterol
  • high blood sugar

Diets high in fructose may also increase a person’s risk of NAFLD. Scientists have also found differences in gut bacteria between people who have NAFLD and those who do not have it. A person may have NAFLD and AFLD at the same time.

Symptoms

NAFLD and AFLD may have few or no symptoms. People with either may have:

• fatigue
• discomfort in the upper right side of their abdomen

Treatment

Doctors recommend weight loss to treat both AFLD and NAFLD. For AFLD, doctors also recommend stopping drinking alcohol. There is currently no approved medication for either condition.

Learn more about fatty liver disease.

Cirrhosis is a condition where the liver is permanently damaged and scarred. The scar tissue from cirrhosis replaces healthy liver tissue and restricts blood flow. Cirrhosis can eventually cause the liver to fail.

Symptoms

People may have no symptoms until cirrhosis has damaged their liver. Early symptoms may include:

• fatigue
• weakness
• poor appetite
• weight loss without an obvious cause
• nausea
• vomiting
• pain in the upper right side of the abdomen

Later symptoms may include:

• easily bleeding or bruising
• sleep disorders
• mental symptoms such as:
  • confusion
  • memory loss
  • difficulty thinking
  • personality changes
• severely itchy skin
• darker urine color
• jaundice, a yellow tint to the whites of the eyes and skin
• edema, swelling in the lower legs, ankles, or feet
• ascites, a buildup of fluid in the abdomen that causes bloating

Cirrhosis may lead to liver failure and other complications.

Treatment

Doctors aim to treat the underlying cause of a person’s cirrhosis to help prevent it from worsening or causing liver failure.

Learn more about cirrhosis.

The outlook for a person’s cirrhosis depends on its progression. There are two stages of cirrhosis:

• Compensated cirrhosis: People with compensated cirrhosis have no symptoms. The life expectancy for those with this stage is about 12 years.
• Decompensated cirrhosis: People with decompensated cirrhosis have one or more symptoms or complications. They may need a liver transplant. The life expectancy for those with this stage is about 2 years.

People may be able to reverse cirrhosis from decompensated to compensated by resolving the underlying cause.

Read more about the outlook for cirrhosis.

The following are some questions people frequently ask about fatty liver and cirrhosis.

How do you know when fatty liver turns to cirrhosis?

People with cirrhosis may have no symptoms. Doctors diagnose cirrhosis with:

• blood tests
• imaging tests
• biopsies, which involve removing a small piece of a person’s liver for laboratory testing

Is fatty liver stage 1 cirrhosis?

People with stage 1 fatty liver do not have cirrhosis. If a person has stage 4 fatty liver, they have cirrhosis.

What is the life expectancy with stage 3 fatty liver?

A person’s life expectancy with stage 3 fatty liver varies based on their age and other factors. In a recent study, scientists created mathematical models to estimate long-term NAFLD outcomes. They estimated the life expectancy of a 49-year-old person with stage 3 fatty liver to be 21.1 years.

It can take several years for a person’s fatty liver to turn into cirrhosis. People with AFLD may develop cirrhosis after 10 years or more. NAFLD may cause a person to develop cirrhosis in fewer years.

People may have no cirrhosis symptoms until their liver has been severely damaged. Doctors treat a person’s cirrhosis by treating the underlying cause.

If a person is concerned that they may be at risk of fatty liver disease or cirrhosis, they should speak with a healthcare professional.