Fatty liver: It can be only fatty change or NASH (meaning fat with inflammation) or even could be early stage of cirrhosis. Only way to know by liver biopsy. About 10 t0 30% of patient with fatty liver disease can develop cirrhosis if they have nash. Normal enzymes doesn't always guarantee everything normal. However, there are some early marker (from blood test), which are red flag for cirrhosis.
Answered 11/28/2017
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Liver Biopsy: Fatty liver and NASH are not the same, with NASH including elements of tissue destruction, inflammation and fibrosis within a background of fatty liver. There are very specific criteria for the diagnosis of nash, which often require obtaining a liver biopsy. Cirrhosis (at least in more advanced cases) often leads to a smaller liver.
Answered 9/28/2016
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