Private Liver Ultrasound London: Fatty Liver, Abnormal Blood Tests, and Why Your Liver Deserves a Scan

Your liver is the largest solid organ in your body and arguably the hardest working. It filters every drop of blood, metabolises drugs and toxins, produces bile, stores energy, and manufactures essential proteins. Most of the time it does all of this silently — which is precisely the problem. By the time liver disease causes noticeable symptoms, significant damage may already have occurred.

Non-alcoholic fatty liver disease — now increasingly referred to as metabolic dysfunction-associated steatotic liver disease (MASLD) following the 2023 international nomenclature update — is the most common liver condition in the UK. The British Liver Trust estimates that approximately 1 in 3 people in the UK have early-stage fatty liver disease. Most have no idea.

A private liver ultrasound is the first investigation recommended for abnormal liver function blood tests, suspected fatty liver, or any liver-related concern. It is safe, painless, uses no radiation, and at The Wellness London, is performed by a GMC-registered doctor who explains findings during the scan and provides a same-day written report.

Concerned about your liver? Message us on WhatsApp or email team@thewellnesslondon.com.

What a Liver Ultrasound Assesses

Liver size. An enlarged liver (hepatomegaly) can indicate fatty liver, hepatitis, congestion from heart failure, or infiltrative conditions. A shrunken liver may suggest advanced cirrhosis.

Liver echogenicity (brightness). A fatty liver appears brighter than normal on ultrasound — brighter than the adjacent kidney cortex. This increased echogenicity is the hallmark ultrasound finding of hepatic steatosis. Your doctor will grade the severity: mild, moderate, or severe.

Liver texture. A smooth, homogeneous liver texture is normal. A coarse, heterogeneous texture may suggest chronic liver disease or early cirrhosis. Surface nodularity is a late sign of cirrhosis.

Focal lesions. The liver is systematically examined for cysts, haemangiomas (the most common benign liver tumour), focal nodular hyperplasia, and masses. The majority of incidental liver lesions on ultrasound are benign.

Portal vein and hepatic veins. Assessed for patency (open flow), dilation, and flow direction. Portal hypertension — reversed flow in the portal vein — is a sign of significant liver disease.

Gallbladder and bile ducts. Routinely included in a liver ultrasound. Gallstones, bile duct dilation, and gallbladder wall thickening are assessed.

Fatty Liver Disease: The Silent Epidemic

Fatty liver disease progresses through several stages, and early stages are entirely reversible:

Stage 1 — Simple steatosis (fatty liver). Fat accumulates in the liver cells without significant inflammation. Most patients have no symptoms. Usually discovered incidentally on blood tests (mildly elevated ALT or GGT) or ultrasound. At this stage, the condition is completely reversible with lifestyle changes — weight loss, dietary improvement, and exercise.

Stage 2 — Steatohepatitis (NASH/MASH). Fat accumulation triggers inflammation and liver cell damage. Blood tests may show more significantly elevated liver enzymes. The liver begins to sustain damage, but this stage is still largely reversible.

Stage 3 — Fibrosis. Repeated inflammation leads to scarring (fibrosis) of the liver tissue. The liver still functions, but structural damage is accumulating. Fibrosis staging (F0–F4) determines prognosis and management urgency.

Stage 4 — Cirrhosis. Extensive scarring replaces normal liver tissue. The liver becomes nodular and its function deteriorates. Cirrhosis significantly increases the risk of liver failure and hepatocellular carcinoma (liver cancer). At this stage, damage is largely irreversible.

The critical point: catching fatty liver early — at stage 1 or 2 — means you can reverse it. The liver has extraordinary regenerative capacity when the cause of damage is removed. This is why screening matters.

Worried about fatty liver? Book your liver scan on WhatsApp.

When Should You Get a Liver Ultrasound?

Abnormal liver function tests (LFTs). Elevated ALT, AST, GGT, ALP, or bilirubin on blood tests. A liver ultrasound is the standard first-line investigation to identify the structural cause.

Suspected or confirmed fatty liver. If your GP has mentioned fatty liver or NAFLD/MASLD, or if you have risk factors (overweight/obesity, type 2 diabetes, metabolic syndrome, high cholesterol).

Alcohol consumption. If you drink regularly or have a history of heavy alcohol use, a liver ultrasound assesses for alcohol-related liver changes including fatty liver, hepatitis, and early cirrhosis.

Right upper quadrant pain. Pain under the right ribs can originate from the liver, gallbladder, or surrounding structures. Ultrasound differentiates between these causes.

Monitoring known liver disease. Patients with established liver conditions benefit from regular ultrasound surveillance.

Hepatitis B or C. Chronic viral hepatitis requires liver monitoring including regular ultrasound.

Medication monitoring. Certain medications (methotrexate, statins at high dose, long-term paracetamol use) can affect the liver. Ultrasound provides structural assessment alongside blood tests.

Family history of liver disease. Conditions like haemochromatosis, Wilson's disease, and alpha-1 antitrypsin deficiency have genetic components.

General health screening. Fatty liver disease is so common that many clinicians now recommend liver assessment as part of routine health screening, particularly for adults over 40 with metabolic risk factors.

Liver Scans at The Wellness London: Pricing

All prices include the doctor-performed scan, verbal debrief, and same-day written report.

Blood tests can be added to any scan appointment: liver function panel, hepatitis B and C serology, ferritin, full lipid profile, HbA1c, and more.

What to Expect

Preparation: Fast for 6 hours (water permitted). This ensures optimal gallbladder visualisation and reduces bowel gas.

Duration: 15–20 minutes for a focused liver scan; 20–30 minutes for upper abdominal assessment.

The scan: You lie on your back and may be asked to turn onto your left side. The doctor applies gel below the right ribcage and systematically examines the liver from multiple angles. Deep breaths help bring the liver into view below the ribcage.

Results: Your doctor explains findings during the scan. A written report is issued the same day.

What Liver Ultrasound Cannot Do

Ultrasound is an excellent first-line investigation but has limitations:

• It cannot precisely quantify the degree of liver fibrosis — transient elastography (FibroScan) or MR elastography provides fibrosis staging
• Mild fatty liver (less than approximately 20% fat content) may not be detectable on standard ultrasound
• Small lesions deep in the liver may be obscured in patients with a larger body habitus
• It cannot differentiate simple steatosis from steatohepatitis — this distinction requires blood tests and sometimes biopsy

Your doctor will explain these limitations and recommend complementary investigations if needed.

Frequently Asked Questions

Can fatty liver be reversed? Yes — at the early stages (simple steatosis and early steatohepatitis). Weight loss of 5–10% of body weight has been shown to significantly reduce liver fat. Dietary improvements, regular exercise, and management of metabolic risk factors (diabetes, cholesterol) are the cornerstones of treatment. Your doctor at The Wellness can discuss evidence-based lifestyle modifications.

Is fatty liver serious? In its early stages, fatty liver is common and manageable. However, if left unaddressed, it can progress to steatohepatitis, fibrosis, and ultimately cirrhosis. The British Liver Trust notes that liver disease is the third leading cause of premature death in the UK and is the only major cause of death still increasing year on year.

Do I need a referral? No. Book directly at The Wellness.

Can I combine a liver scan with other scans? Yes. The upper abdominal ultrasound (£225) includes the liver plus gallbladder, pancreas, spleen, kidneys, and aorta — the most efficient way to check all upper abdominal organs in one visit.

Book Your Liver Ultrasound

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📧 Email: team@thewellnesslondon.com

🌐 Book online: thewellnesslondon.com/ultrasound

This article was reviewed by the clinical team at The Wellness London. All scans are performed by GMC-registered doctors. Last updated March 2026.

Medical disclaimer: This information is for educational purposes and does not replace professional medical advice. If you have been diagnosed with liver disease, please follow up with your treating physician.