Why It Is Important To Screen For Fatty Liver In Singapore

Non-Alcoholic Fatty Liver Disease is a common chronic liver disease in Singapore. In “westernised” Asian countries, including Singapore, it is estimated to affect as much as 40% of the population. Fatty liver disease itself usually does not present any symptoms, but if left untreated, there is a possibility of liver scarring (cirrhosis) and liver cancer. This is why it is important to go for regular health check-ups and screen for fatty liver.

What Is Non-Alcoholic Fatty Liver Disease?

Non-Alcoholic Fatty Liver Disease is a condition that affects people who consume little or no alcohol. It happens when excess fat gets deposited in the liver, even though the patient is not a regular consumer of alcohol. The accumulated fats may irritate the liver cells and cause them to become inflamed and die. Dead liver cells die are then replaced by scar tissue. Such scar tissue is stiff and in turn may interfere with the normal functioning of the liver. Importantly, this also results in an increase in the risk of contracting liver cancer.

While most patients do not suffer serious consequences from this disease, about 30% do end up having liver inflammation and scarring. Of those that do, about 20% will develop end-stage cirrhosis, which may then cause liver cancer.

Symptoms Of Fatty Liver Disease

Patients with Non-Alcoholic Fatty Liver Disease typically do not present any symptoms. If there are any symptoms, they may be non-specific ones, such as fatigue, nausea and upper abdomen discomfort on the right side. If liver cirrhosis develops however, symptoms of cirrhosis may appear. Symptoms of advanced cirrhosis include:

• Jaundice.
• Vomiting of blood.
• Itchy skin.
• Dark urine.
• Light-coloured stool.
• Bleeding or bruising easily.
• Swollen legs or tummy.
• Loss of sex drive.

Risk Factors For Fatty Liver Disease

The causes for fatty liver disease are not known, but people with the following risk factors have a higher chance of developing the disease:

• Diabetes.
• Obesity (BMI > 25 in Asian people).

• Waistline exceeding 90cm (Asian men) or 80cm (Asian women).
• High cholesterol.
• Hypertension.
• Metabolic syndrome
• Obstructive sleep apnea, polycystic ovary syndrome, underactive thyroid, underactive pituitary, and other associated conditions.

Screen For Fatty Liver Disease

Given the potential serious consequences and the prevalence of the disease, it is important to screen for fatty liver on a regular basis. Non-Alcoholic Fatty Liver Disease may be discovered via:

• Liver function tests to spot for elevated liver enzymes (ALT, AST).
• Ultrasound, magnetic resonance imaging (MRI), or computed tomography (CT) scans.
• If the disease is found, patients might need further blood tests to ascertain the severity of the disease or to exclude other liver diseases, or a liver biopsy to determine the stage of the disease.

Treatment For Fatty Liver Disease

If fatty liver is discovered, treatments to manage the disease may include:

Lifestyle Modifications

• Losing weight healthily.
• Keeping to a well-balanced diet.
• Having regular exercise.

Treatment of Associated Factors

• Control of diabetes, hypertension, obesity, cholesterol
• Medications

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