What is fatty liver disease?

Non-alcoholic fatty liver disease (NAFLD), or fatty liver disease to a layperson, is a condition where excessive fat builds up in the liver. In Singapore, the incidence can be as high as 40% and is known to be more common in people with diabetes, obesity, high cholesterol as well as sedentary lifestyle.

What are the symptoms and signs of fatty liver disease?

Most patients with fatty liver disease are asymptomatic although they sometimes present with abnormal liver function test (LFT). As such, patients with risk factors (obesity, diabetes, dyslipidemia) may be advised to undergo screening for early detection and intervention.

What should I do if I have fatty liver disease?

The majority of patients  can be managed at outpatient clinics (GP, family physicians). Treatment is targeted at managing the underlying condition (diabetes, obesity etc) as well as lifestyle intervention aimed at weight loss, diet control and promoting regular exercises.

When should I see a liver specialist?

Depending on the initial finding, liver specialist (Gastroenterologist) consult is necessary especially if some of these tests are abnormal. Additional investigations may need to be performed to rule out other conditions such as viral hepatitis, autoimmune hepatitis etc which may present similarly or even co-exist with NAFLD.

NAFLD may progress to a more severe condition (steatohepatitis), and without intervention this may further progress to liver fibrosis and cirrhosis (hardening of liver). Liver cirrhosis is an independent risk factor for the development of decompensated liver disease, liver cancer or even liver failure. In such advanced stage of liver disease, specialist management is also necessary to manage possible complications.