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Dr. Ravishankar Kumar, Patna (2025)

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Dr. Ravishankar Kumar
Dr-Ravishankar Kumar

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Dr. Ravishankar Kumar
Dr-Ravishankar Kumar

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Dr. Ravishankar Kumar
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Hypertension (High Blood Pressure)
Hypertension (high blood pressure) means your blood is pushing too forcefully against your artery walls. Many people have this condition but don’t know it because it usually has no symptoms. Without treatment, it can lead to a heart attack, stroke, dementia, kidney disease and other issues. Early diagnosis and treatment can be lifesaving.

What Is Hypertension?
Anatomy of high blood pressure in an artery wall, with systolic and diastolic numbers
High blood pressure means the force of blood against your artery walls is too high.
Hypertension, or high blood pressure, means the force of blood pushing against your artery walls is too high. This makes your heart work harder to pump blood through your body. Over time, hypertension damages your arteries and heart. It can lead to serious complications, like a heart attack or stroke. Because high blood pressure usually doesn’t cause symptoms, it’s often known as a “silent killer.”

Healthcare providers measure blood pressure (BP) in millimeters of mercury (mmHg). Your reading has two numbers:

Systolic blood pressure: This is the top number. It’s the pressure on your artery walls when your heart contracts.
Diastolic blood pressure: This is the bottom number. It’s the pressure between beats when your heart relaxes.
What’s considered high blood pressure varies slightly based on where you live. In the U.S., healthcare providers define it as:

A top number (systolic BP) of 130 mmHg or higher, OR
A bottom number (diastolic BP) of 80 mmHg or higher
In Europe, providers define hypertension as a top number of 140 or higher, or a bottom number of 90 or higher.

High blood pressure is very common. It affects nearly half of all adults in the U.S. It’s a major risk factor for cardiovascular disease.

Types of hypertension
There are two main types of high blood pressure, based on what’s causing it:

Primary hypertension: This means your genetics, family history and age are the primary causes of your high blood pressure.

Secondary hypertension: This means there’s an identifiable cause, like a medical condition, medication or addictive substance, that is making your blood pressure high.

You might also hear about high blood pressure that occurs in certain situations. These types are:

White coat hypertension: Your BP is normal at home, but high in a healthcare setting.
Masked hypertension: Your BP is normal in a healthcare setting but high at home.
Sustained hypertension: Your BP is high no matter where you are.
Nocturnal hypertension: Your BP goes up when you sleep.
Symptoms and Causes
Symptoms of high blood pressure
Hypertension usually has no symptoms. You could have it for years without feeling any clues. In fact, the World Health Organization estimates that 46% of adults with hypertension don’t know they have it.

If your blood pressure is extremely high, you may have symptoms like:
Changes to your mental function
Chest pain
Dizziness
Edema (swelling)
Heart palpitations
Peeing less than usual
Seizures
Severe headache
Signs of stroke, like sudden facial droop, slurred speech or sudden arm/leg weakness
Vision changes, like eye pain, vision loss or sudden blurry vision
This is called a hypertensive emergency. your local emergency services number right away if your blood pressure is 180/120 or higher and you have any of the symptoms above. If you’re pregnant, call for help if your BP is 160/110 or higher with symptoms.

What causes high blood pressure?
Healthcare providers can’t find a single cause of hypertension for most people. Instead, many factors can come together to make your blood pressure higher. These include:

Being over age 55
Having a history of the condition in your biological family
Smoking or using to***co products
Having overweight/obesity
Eating foods high in sodium
Not getting enough physical activity
Drinking too much alcohol
In some cases, providers can find a specific cause of your high blood pressure, like an underlying condition, medication or substance. Here are some examples:

Conditions, like obstructive sleep apnea, renal artery stenosis, primary aldosteronism and thyroid disease
Medications, like those that manage ADHD, inflammation, autoimmune disease and mental health conditions
Addictive substances, like alcohol, ni****ne and co***ne
Complications of this condition
Untreated hypertension damages your arteries and overworks your heart. Over time, it may lead to:

AFib: A chaotic rhythm in your heart that affects how well it can pump blood
Chronic kidney disease: Problems with your kidney function that can get worse over time
Cognitive impairment and dementia: Changes to your thinking, memory and personality
Coronary artery disease: Narrowed or blocked arteries in your heart
Heart attack: A sudden lack of blood flow to your heart
Heart failure: A long-term condition that affects your heart’s pumping ability
Hypertensive retinopathy: Damage to your eyes that may lead to vision loss
Peripheral artery disease: Narrowed or blocked arteries in your legs or arms
Erectile dysfunction: Difficulty in obtaining an er****on
Stroke: A sudden lack of blood flow to your brain that can cause long-term neurological changes

Diagnosis and Tests
Stage 1 hypertension is a top number of 130 to 139 or a bottom number of 80 to 89. Stage 2 is even higher.
High blood pressure means your top number is at least 130 or your bottom number is at least 80. Stage 2 is more severe than stage 1.

How doctors diagnose this condition
Healthcare providers measure your blood pressure at your yearly check-ups and other appointments. This lets them see if it’s normal or too high. They’ll diagnose you with hypertension if your numbers are high at two separate visits (with at least two readings taken each time).

What are the different stages of hypertension?
There are two main stages of hypertension:
Stage 1 means your top number is in the 130s, or your bottom number is in the 80s.
Stage 2 means your top number is 140 or higher, or your bottom number is 90 or higher.
On either end of these stages, there are other categories that providers use to guide treatment decisions:

Elevated blood pressure is blood pressure that’s a bit above normal but not yet diagnosed as hypertension.
Severe hypertension is dangerously high blood pressure that’s not yet causing organ damage.
A hypertensive emergency is dangerously high blood pressure that’s damaging your organs. It causes symptoms and is a medical emergency.
This chart lists these categories and the thresholds for each:

Category Top number (systolic BP), in mmHg And/or Bottom number (diastolic BP), in mmHg
Normal blood pressure Below 120 AND Below 80
Elevated blood pressure 120 to 129 AND Below 80
Stage 1 hypertension 130 to 139 OR 80 to 89
Stage 2 hypertension 140 or higher OR 90 or higher
Severe hypertension 180 or higher OR 120 or higher
Hypertensive emergency 180 or higher, with symptoms OR 120 or higher, with symptoms
High systolic blood pressure vs. high diastolic blood pressure
It’s common for both your top number (systolic) and your bottom number (diastolic) to be too high. But it’s also possible for just one to be in the hypertensive range. You might hear your provider use these terms to describe your blood pressure:

Isolated systolic hypertension, or high systolic blood pressure: Your top number is 130 or higher, but your bottom number is below 80. This is more likely to happen as you get older and your arteries get stiffer.
Isolated diastolic hypertension, or high diastolic blood pressure: Your bottom number is 80 or higher, but your top number is below 130. This is less common overall and typically affects younger adults.

Management and Treatment
How is high blood pressure treated?
Hypertension treatments include medications to lower your blood pressure and changes to your daily habits. Common medicines prescribed for high blood pressure include diuretics, beta-blockers, calcium channel blockers, ACE inhibitors and ARBs. Your provider will recommend the right treatment plan for you based on your blood pressure readings, the cause of your high blood pressure and any other conditions you may have.

In general, changes to your habits — sometimes called “lifestyle changes” — are a key part of treatment for everyone. This is true even if you’re taking medicine. In some cases, providers recommend making changes for a while before starting medicine. It depends on your medical history and risk for a heart attack or stroke.

Changes you can make to lower your blood pressure include:
Keep a weight that’s healthy for you. Your healthcare provider can give you a target range.

Eat nutritious foods. A couple of examples are the DASH diet and the Mediterranean diet. These ways of eating are full of fruits, vegetables, whole grains and low-fat dairy. They’re also low in sodium and cholesterol.

Cut down on sodium. Try to limit your sodium intake to no more than 1,500 milligrams (mg) per day. If this is too hard at first, start by reducing your daily intake by at least 1,000 mg.

Get enough potassium. Try to get 3,500 to 5,000 milligrams per day. Ideally, this should be through foods rather than supplements. Some foods high in potassium include bananas, avocados and potatoes (with skin).

Get enough physical activity. Ask your healthcare provider what’s safe for you and how to get started. In general, start slow and work your way up to 150 minutes of aerobic exercise per week. Strength training is also helpful for your heart and whole body.

Quit smoking. Quitting lowers your blood pressure and has many other benefits. Your provider will help you make a plan. This may include support groups, ni****ne replacement therapy and prescription medicine that can make quitting easier.

Limit or avoid alcohol. If you choose to drink, do so in moderation. This means one or fewer drinks per day for females, and two or fewer per day for males. The fewer drinks, the better.
Doing these things can also help prevent high blood pressure if your numbers are currently in the normal range.

When should I see my healthcare provider?
See your healthcare provider for yearly check-ups. They’ll measure your blood pressure and look for changes over time. High blood pressure usually doesn’t cause symptoms or make you feel any different. So, these check-ups are crucial and even lifesaving.

Call your provider if you notice your BP is higher than usual when you check it at home. They may ask you to come in so they can measure it.

If you’re pregnant, call your provider if your BP is ever 160/110 or higher (but if you have symptoms, seek emergency care instead).

Prognosis
What can I expect if I have high blood pressure?
Once you’re diagnosed with hypertension, you’ll work closely with your healthcare provider to manage it. It’s important to:

Take your medicines as prescribed. If you have any side effects, tell your provider. They may change the dose or prescribe something else for you. Don’t skip doses or stop taking your medicine unless your provider says you should.
Make the changes your provider recommends. These might include quitting smoking, eating less sodium or moving around more.
Check your blood pressure at home. Your provider may recommend that you do this and keep a log. Make sure your device is validated (tested for accuracy). Your provider may also ask you to bring your device to the office to ensure the readings match theirs.
Tell your provider about any changes to your health. They may need to adjust your treatment plan over time. Tell them if you get any new diagnoses, start taking new medicines or become pregnant.
How long does high blood pressure last?
If you have primary hypertension, you’ll need to manage it for the rest of your life. Your healthcare provider will help you do this. Secondary hypertension can often be reversed by treating or removing the underlying cause. Your provider will explain how treatment can help and what to expect.
Dr. Ravishankar Kumar Dr-Ravishankar Kumar

06/10/2025

Nose Breathing vs. Mouth Breathing: Which Is Better?

Breathing through your nose is far better for you, but depending on your anatomy, that may not always be possible

Older person deep breathing
You’ve probably been told in certain situations to “Breathe in through your nose and out through your mouth,” especially during exercise or meditation or to relax. But have you ever wondered why?

Part of the reason is simple: Breathing through your nose is the most beneficial way to breathe. Pulmonary medicine specialist Jason Turowski, MD, says that it has to do with evolution — and all the little things that happen as we take that breath, from filtering and humidifying the air to releasing nitric oxide.

Humans are naturally designed to breathe through our noses from birth. It’s the way we’ve evolved. “When we’re newborns, we breathe in and out through our noses almost all the time,” Dr. Turowski explains. “This is related to how our throats are configured, so we can breathe and suckle at the same time without choking. It’s a survival mechanism.”

There are good reasons why we continue to default to nasal breathing as we get older, too. To start, inhaling through your nose offers many more benefits to your body than taking in air through your mouth.

Our noses are designed to process the air that comes in very differently than our mouths. These are intentional and functional parts of our body’s design to keep us safe and healthy. So, why do we ever breathe with our mouths?

Why we breathe in different ways
Some people use the term “mouth breather” as an insult, a way of suggesting a person lacks intelligence. It’s a mean thing to say. It’s also wrong. Most people use both their noses and mouths to breathe. And which type of breathing we favor has nothing to do with intelligence.

If you’re more inclined to breathe through your mouth, you may have:

Congestion issues. We all breathe through our mouth when we’re dealing with allergies, a head cold, sinus issues or run-of-the-mill stuffiness. For some people, nasal congestion is a chronic issue.

Enlarged adenoids. When these glands, which sit above the roof of your mouth and behind your nose, get swollen or infected, they can block your nasal airways. Adenoids shrink around the age of 7 or 8 and are gone by the time you reach adulthood, but some children can’t wait that long. They have to have their adenoids surgically removed.

A deviated septum. Whether you were born with it or broke your nose somewhere along the way, a crooked nasal passage can interfere with breathing and cause chronic congestion issues.

Shortness of breath. Maybe you have asthma or severe acid reflux. Maybe you have an anxiety disorder that leaves you feeling like you can’t take a full breath. Maybe you have a heart or lung condition. Whatever the reason, a person with chronic shortness of breath (dyspnea) may rely on mouth breathing because it moves more air more quickly.

If you don’t have any of these conditions, but inhale through your mouth more often than not, you may want to mention it the next time you’re at your doctor or dentist’s office. (It’s not an emergency unless you’re struggling to breathe.) You may have an underlying condition that, if treated, could make breathing through your nose more comfortable.

Benefits of nose breathing
Here are all the good things your nose does that your mouth doesn’t when you breathe in:

Controls the air temperature. Your lungs aren’t huge fans of air that’s too hot or cold. Unless you have an obstruction (like a deviated septum or chronic rhinitis), your nasal passageways will warm (and sometimes cool, when needed) the air on its way to your lungs. For example, Dr. Turowski notes that winter runners who breathe deeply through their noses get warmed air without sending a chill to their lungs, versus those who breathe with their mouths.

Filters the air. The cilia in your nasal passageway filter out debris and toxins in the air and send them directly down your throat instead of into your lungs. Yes, that sounds gross. But it’s better for that crud to end up in your stomach than anywhere else. Mouth breathing sends whatever’s in the air directly into your lungs, which could raise your risk of infection.

Humidifies the air. According to Dr. Turowski, the passages in your nose are specifically designed to humidify the air you breathe. Your mouth isn’t. That’s part of the reason you occasionally wake up with a dry mouth or a sore throat. Chances are you spent your evening fighting nature by mouth-breathing and didn’t get the humidifying or moisture-balancing benefits of nasal breathing.

Smells the air. Your nose is the gateway to your olfactory system. Groundbreaking stuff, we know. But a sense of smell is important! Your nose helps you stay safe by detecting harmful toxins in the air and in your food. Sure, you might want to switch to mouth breathing if the friendly neighborhood skunk mists your dog or you’re dealing with hyperosmia. But otherwise, the ability to take a whiff of the world around you is a good thing.

Receives pheromones. Speaking of smells, your nose plays a critical role in your perception of s*x. Perfume, sweat, pheromones: Our ability to smell is key to s*xual arousal. Loss of smell (anosmia) can actually lead to a decreased s*x drive. That’s right: Mouth breathing can be a real turn off!

Releases nitric oxide. Nitric oxide (NO) is a chemical our body produces. It’s a vasodilator, meaning it opens up your blood vessels. When our blood vessels are dilated, more blood and oxygen can move through them. The result: Lower blood pressure and better oxygen circulation.

Limits hyperventilation. It’s incorrect to say that you can never hyperventilate through your nose, but it’s much harder. The reason is simple: You can’t inhale as much air through your nasal passages as you can through your mouth.

Potential side effects of mouth breathing
There are clearly plenty of benefits to breathing in through your nose. But that’s not all. Dr. Turowski says there are also clear downsides to breathing in through your mouth.

Saliva plays a crucial role in our oral health. It keeps our mouths lubricated, protects our enamel, and drowns out harmful materials like sugar and acid. Breathing through your mouth robs your saliva, so all those nasties sit on your teeth longer. That can lead to chronic bad breath (halitosis), gingivitis, cavities and other periodontal problems.

Breathing through your mouth can also cause (or contribute to):

Snoring or sleep apnea.
Daytime sleepiness.
Chapped or cracked lips.
Drooling.
Allergies.
Behavior issues in children.
Jaw and facial differences.
So, what’s the verdict? Is nose breathing always better?
Dr. Turowski says that if you aren’t living with a health condition that prevents it, there are only two times that you really need to engage in mouth breathing:

When you need to get more air to your lungs quickly.
When your nasal passage is blocked due to congestion, allergies or a cold.
You’ll still lose out on those benefits that breathing through your nose provides, but — on those specific occasions — it’s a worthwhile trade.

How to adjust your breathing
If you usually breathe through your mouth and want to change that, Dr. Turowski recommends seeing a healthcare provider. Mouth breathing isn’t our natural default, so there’s frequently a reason you’re doing it. Before you try to make any big changes, it’s best to find out what that reason is. In some cases, mouth breathing simply can’t (and shouldn’t) be avoided.

Let’s say you find out that your mouth breathing is simply a bad habit or a side effect of a condition like anxiety. In those cases, breathwork may help you both break the habit and feel more relaxed. Here are a few techniques to get you started:

Alternate nostril breathing.
Diaphragmatic breathing.
Box breathing.
4-7-8 breathing.
Building awareness of your breath can only help you. But other strategies for stopping mouth breathing can be downright dangerous. In particular, Dr. Turowski warns against mouth taping.

If you’re not sure whether your nose breathing strategy is safe, ask a provider’s advice.

Is it ever too late to fix mouth breathing?
When it comes to “fixing” mouth breathing, don’t ask if it’s too late. Ask if the symptoms it’s causing are having a negative impact on your quality of life — and what it would take to correct the problem.

Your answer will depend on what’s causing the issue. If all it’s going to take is adding an over-the-counter allergy treatment to your daily medications, that’s a change worth making. If you’re inhaling through your mouth because your congestive heart failure or chronic obstructive pulmonary disease (COPD) leaves you feeling breathless, your and your provider’s priority will probably be managing the dyspnea, not the mouth breathing.

Is it bad if I keep mouth breathing?
Mouth breathing isn’t ideal, but it isn’t the end of the world either. If you aren’t bothered by symptoms and don’t have any underlying medical conditions that require treatment, changing the behavior is a personal choice.

That said, working with a provider to home in on the cause of your mouth breathing may uncover a health condition you didn’t know you had. And addressing that condition may mean better sleep, drama-free dental appointments, a healthier, happier mindset or fewer days spent coughing and sputtering with allergies. And incorporating breathing exercises into your daily routine is a great way to practice mindfulness and reduce stress.

So, have a conversation with a provider about your breathing. That way, whatever you choose to do, you’ll be making an informed choice.

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Steatotic (Fatty) Liver Disease
Steatotic liver disease (SLD) involves having excess fat in your liver. Metabolic conditions and heavy alcohol use are risk factors. Depending on the type of SLD you have, the fat buildup may not cause problems, or it may lead to liver damage. Often, you can prevent or even reverse SLD with medications and lifestyle changes.

Your liver is the biggest organ in your body and it performs hundreds of functions every day.
What is steatotic (fatty) liver disease?
Steatotic liver disease (SLD) includes several conditions associated with steatosis in your liver. “Steatosis” is a term healthcare providers use to describe fat buildup in an organ (usually your liver). A healthy, high-functioning liver contains a small amount of fat. Fat buildup becomes a problem when it reaches over 5% of your liver’s weight.

Why was fatty liver disease renamed steatotic liver disease?
Previously, steatotic liver disease was known as “fatty liver disease.” In 2023, experts renamed the condition and its subcategories to reflect its causes more accurately. For example, while some conditions associated with fat composition in your body (like obesity) can increase your risk of steatosis, there are several risk factors unrelated to weight or body mass index (BMI).

The renaming also avoids language that’s potentially stigmatizing toward people with SLD.

What are the types of steatotic (fatty) liver disease?
Healthcare providers classify SLD based on its causes and the conditions associated with it.

The progression of liver disease: Starting with a healthy liver, then a fatty liver and finally cirrhosis.
Without treatment, some types of fatty liver disease can lead to irreversible scarring (cirrhosis of the liver).
Alcohol-related liver disease (ALD)
With ALD, steatosis occurs because of excessive alcohol consumption. Each time your liver filters alcohol, some of its cells die. Usually, your liver can make new cells to replace the old ones, so there isn’t a problem. But if you drink too much alcohol, your liver may not be able to keep up. Instead, steatosis may set in.

Metabolic dysfunction-associated steatotic liver disease (MASLD)
Previously, healthcare providers referred to MASLD as non-alcohol related fatty liver disease (NASLD) because the steatosis isn’t associated with heavy alcohol consumption. Experts renamed the condition to reflect what the fat buildup in your liver is associated with. With MASLD, the culprit is cardiometabolic risk factors. These factors include conditions and characteristics that pose risks to your heart health.

Risk factors associated with MASLD include:

Obesity.
Type 2 diabetes.
High blood pressure.
Lipid abnormalities (lipids are fatty compounds found in cells).
MASLD also applies if you consume small amounts of alcohol weekly. “Small amounts” means less than 140 grams per week for females and less than 210 grams per week for males. For reference, in the U.S., one standard, 12-oz. beer contains about 14 grams of alcohol.

Metabolic-associated steatohepatitis (MASH)
Metabolic-associated steatohepatitis (MASH) is a serious form of MASLD. With MASH, fat buildup progresses to inflammation, then tissue damage and scarring (fibrosis). Previously, healthcare providers referred to MASH as non-alcohol related steatohepatitis (NASH).

MASLD and increased alcohol intake (MetALD)
If you have MetALD, both metabolic risk factors and alcohol consumption play a role in fat buildup in your liver. With MetALD, you have a cardiometabolic risk factor and consume more than 140 grams per week (female) or more than 210 grams per week (male).

What contributes most to the fat buildup in your liver (alcohol consumption or metabolic risk factors) varies from person to person.

Other forms of SLD
SLD can result from causes other than alcohol use or cardiometabolic risk factors. For example, various medications and diseases can cause steatosis. Sometimes, healthcare providers can’t identify a specific cause. SLD without a clear cause is called cryptogenic SLD.

Is steatotic (fatty) liver disease a serious problem?
In most cases, the fat buildup doesn’t cause serious problems or prevent your liver from functioning normally.

In some cases, the condition progresses to liver disease. It usually progresses in stages:

Hepatitis: Your liver goes from fatty to inflamed (swollen). The inflammation damages tissue. This stage is called steatohepatitis. For example, this is what happens when MASLD becomes MASH.

Fibrosis: Bands of scar tissue form where the inflammation damages your liver, causing it to stiffen. This process is called fibrosis.

Cirrhosis: Extensive scar tissue replaces healthy tissue. At this point, you have cirrhosis of the liver. Without treatment, cirrhosis can lead to potentially fatal conditions like liver failure and liver cancer. About 90% of people who develop hepatocellular carcinoma (HCC) — a type of liver cancer — have cirrhosis.
This is why it’s so important to learn what’s causing fat buildup in your liver and get treated. Even if you have early-stage cirrhosis, there are steps you can take to protect your liver from further damage. In some instances, you can even reverse some damage by following your provider’s treatment plan for you.

Symptoms and Causes
What are the signs and symptoms of steatotic (fatty) liver disease?
SLD doesn’t always cause symptoms. When they’re present, symptoms include:

Abdominal pain or a feeling of fullness in the upper right side of your abdomen (belly).
Extreme exhaustion or weakness (fatigue).
More commonly, people notice symptoms once SLD has progressed to cirrhosis of the liver. When cirrhosis develops, you may experience:

Nausea.
Loss of appetite.
Unexplained weight loss.
Yellowish skin and whites of the eyes (jaundice).
Swelling in your abdomen (ascites)
Swelling in your legs, feet or hands (edema).
Bleeding (that your provider finds in your esophagus, stomach or re**um).
What causes steatotic (fatty) liver disease?
SLD has multiple causes. Still, you’re more likely to develop SLD if you have a cardiometabolic risk factor, if you consume unhealthy amounts of alcohol or both.

You have a greater chance of developing SLD if you:

Have alcohol use disorder (frequent or heavy alcohol use).
Have metabolic syndrome (insulin resistance, high blood pressure, high cholesterol and high triglyceride levels).
Have Type 2 diabetes.
Have overweight (BMI 25 to 29.9 kilograms kg/m2).
Have obesity (BMI 30 kg/m2 and above).
Have polycystic o***y syndrome (PCOS).
Have obstructive sleep apnea.
Have hypothyroidism (low thyroid hormones).
Have hypopituitarism (low pituitary gland hormones).
Have hypogonadism (low s*x hormones).
Take certain prescription medications, such as amiodarone (Cordarone), diltiazem (Cardizem), tamoxifen (Nolvadex) or steroids. (Fat buildup in your liver can be a medication side effect.)

What are the complications of SLD?
Without treatment, a steatotic liver can progress to cirrhosis of the liver, which can lead to liver failure, liver cancer and cancers outside your liver. People with MASLD are also at increased risk of heart disease. Heart disease — not liver disease — is the leading cause of death in people with MASLD.

Diagnosis and Tests
How is steatotic (fatty) liver disease diagnosed?
Because SLD doesn’t usually cause symptoms, your healthcare provider may be the first to notice an issue. High levels of liver enzymes that turn up on a blood test for other conditions may raise a red flag. Elevated liver enzymes are a sign your liver is injured.

To make a diagnosis, your provider may perform:

A medical history that includes questions about your conditions, how much alcohol you drink and which medicines you’re taking.
A physical exam to check for signs of inflammation, like an enlarged liver, or signs of cirrhosis, like jaundice.
Imaging procedures, including an ultrasound, CT scan (computed tomography scan) or MRI (magnetic resonance imaging), to check your liver for signs of inflammation and scarring. They may order a specialized ultrasound called FibroScan to learn the amount of fat and scar tissue in your liver.
A liver biopsy (tissue sample) to determine how far the liver disease has progressed. A liver biopsy is the only way to distinguish MASLD from MASH.

Management and Treatment
How is steatotic (fatty) liver disease treated?
There’s no specific treatment or medications. Instead, providers focus on helping you manage risk factors that contribute to the condition. This includes making lifestyle changes that can improve your health.

Your provider may recommend that you:

Avoid alcohol: Steer clear of alcohol even if your SLD isn’t related to alcohol use.
Lose weight: Exercising, changing what you eat and drink (under the supervision of a nutritionist) and taking medications, such as GLP1RA, can help with weight loss. You may qualify for bariatric surgery, which can also help you lose weight.
Take medications to manage metabolic conditions: Take prescribed medicines to manage diabetes, cholesterol and triglycerides (fat in the blood). You may also need to take vitamin E and thiazolidinediones (drugs used to treat diabetes, such as Actos and Avandia) in specific instances.
Get vaccinated for hepatitis A and hepatitis B: These viral infections are especially dangerous if you already have liver disease.
Your provider may change your prescriptions if your medicine is causing fat to accumulate in your liver.

Prognosis
Does steatotic (fatty) liver disease go away?
Depending on the severity of your condition, it’s possible to get rid of SLD and even some scarring. Your liver has an amazing ability to repair itself. If you follow your provider’s treatment plan, it’s possible to reduce liver fat and inflammation. You can prevent the damage from worsening and, in some cases, reverse early liver damage.

Will SLD kill you?
SLD doesn’t cause major problems for most people unless they develop advanced cirrhosis. Many people with SLD have a normal life expectancy.

Untreated cirrhosis of the liver eventually leads to liver failure or liver cancer. Your liver is an organ you can’t live without. This is why it’s so important to protect your liver if you learn you have SLD.

Prevention
How can steatotic (fatty) liver disease be prevented?
The best way to avoid SLD is to maintain your overall health:
Exercise regularly.
Limit your alcohol consumption.
Maintain a weight that’s healthy for you.
Take medications as prescribed if you have Type 2 diabetes or metabolic syndrome.
Living With

What is a good diet to follow with SLD?
If your SLD is weight-related, follow a balanced diet to lose weight slowly but steadily. Healthcare providers often recommend steering clear of sugar and trying the Mediterranean diet, which is high in vegetables, fruits and good fats. Other foods and diets rich with nuts, seeds, whole grains, and fish and chicken are helpful food choices for SLD. It’s also important to avoid eating too much red meat or drinking sugary beverages.

Ask your doctor or nutritionist for advice on healthy weight loss techniques.

Consider steatotic liver disease a warning sign that can help you take steps to avoid a fatal liver condition like cirrhosis or liver cancer. Having too much fat in your liver isn’t the same as scarring — which is much more serious. Work with your healthcare provider to understand if you’re at risk of developing inflammation or scarring in your liver. If you are, focus on managing causes and contributing factors, including alcohol use and metabolic syndromes. You can take steps to protect your liver, improve your health and even potentially save your life.

Dr. Ravishankar Kumar

Dr. Ravishankar Kumar

11/10/2025

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