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Fatty Liver

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What is Fatty Liver?

The liver has a very important role to play in the maintenance of human life. It is responsible for the removal of toxins, maintaining metabolic homeostasis, and producing essential proteins.

Fatty liver or steatosis is a common medical condition in Singapore that affects a large number of individuals. While it is normal to have a small amount of fat in the liver, too much fat or a buildup of fat can result in fatty liver. An excess of fat in the liver can result in inflammation which damages the liver and causes scarring.

There are two main types of fatty liver:
Alcoholic fatty liver
  • Preventable: usually gets better when alcohol consumption ceases; common in individuals who drink excessively (more than 2 drinks a day for men, more than 1 drink for women).
  • Enlarged liver: may not cause symptoms or may cause a mild discomfort at the upper right side of your abdomen.
  • Alcoholic hepatitis: swollen liver that can cause a variety of symptoms.
  • Alcoholic cirrhosis: buildup of scar tissue in the liver.
Non-alcoholic fatty liver
  • Common: occurs in individuals who do not drink; most common type of fatty liver disease, affecting approximately 40% of Singaporeans.
  • Simple fatty liver: some fat is present in the liver but not enough to cause inflammation or damage to liver cells; does not usually get worse or cause any problems.
Nonalcoholic steatohepatitiss (NASH): inflammation in the liver causes damage in the liver cells resulting in fibrosis (reversible liver scarring) and then cirrhosis (irreversible liver scarring), which could ultimately result in liver failure.

What causes Fatty Liver?

In general, fatty liver is caused by the buildup or accumulation of fat in the liver. Some storage of fat in the liver is normal, as the liver will convert this fat to glucose and glycogen to provide energy to the body. However, if the amount of fat is more than 5% of the liver, fatty liver disease occurs.
In individuals with alcoholic fatty liver, the excess fat comes from prolonged consumption of alcoholic drinks. Whereas for individuals with nonalcoholic fatty liver, the excess fat comes from an unhealthy lifestyle.

What are the common symptoms of Fatty Liver in Singapore?

For most people, fatty liver does not cause any symptoms. Occasionally, you may feel lethargic, tired, or a mild discomfort in the upper right side of your abdomen. However, fatty liver disease has 4 stages: simple fatty liver, steatohepatitis, fibrosis, and cirrhosis. 

If fatty liver has progressed to liver cirrhosis, the follow symptoms may occur:

  • Fever
  • Nausea
  • Vomiting
  • Abdominal pain
  • Jaundice
  • Loss of appetite
  • Fatigue or lethargy
  • Easy bruising or bleeding
  • Breast enlargement in men
  • Swelling in your legs
  • Dark urine

Is Fatty Liver painful?

The initial stages of fatty liver do not cause any symptoms, let alone any pain. However, if your fatty liver has progressed to liver cirrhosis, you may experience some abdominal pain.

Who is at risk of Fatty Liver in Singapore?

There are various factors that increase your risk of fatty liver, these are:

  • High consumption of alcohol: excessive consumption of alcohol will increase your risk of alcoholic fatty liver; more than 2 drinks for men and more than 1 drink for women, in a day.
  • Age: the older you are, the higher the risk.
  • Genetics: if you have family members who have fatty liver, your risk increases.
  • Obesity: obesity is a risk factor for many diseases including fatty liver; this is particularly true if you have a high level of fat around your abdomen.
  • Smoking: increases your risk of fatty liver.
  • Hepatitis C: having a history of hepatitis C (which is an infection of your liver), can increase your risk of fatty liver.
  • Insulin resistance/type 2 diabetes: individuals with type 2 diabetes, have a two-fold increase to develop fatty liver.
  • High cholesterol and triglycerides level: have been found to be a main cause of fatty liver. 
  • Pregnancy: pregnant women are at risk of acute fatty liver. This increases the risk of both mother and baby, including hypertensive complications of pregnancy, preterm birth, and heavy bleeding at birth.
  • Polycystic ovarian syndrome (PCOS): nonalcoholic fatty liver is common in women with PCOS.
  • Obstructive sleep apnea: increases the incidence of fatty liver by causing insulin resistance, imbalance of lipids such as triglycerides and cholesterol, and inflammation.

How is Fatty Liver diagnosed?

Fatty liver may first show up on your annual blood test, this is observed when there are higher levels of liver enzymes. Once this occurs, your gastroenterologist may use the following tests for accurate diagnosis:

  • Ultrasound or computed tomography scan (CT-scan)
  • Biopsy of the liver where a sample is taken to see how far your fatty liver has progressed
  • FibroScan® which is a special kind of ultrasound that can check for the amount of scarring and fat in the liver

What are the treatment options for Fatty Liver in Singapore?

There are currently no treatment options for fatty liver, but there are certain lifestyle changes that can be made which may reverse your fatty liver if it has not reached stage 4, liver cirrhosis. Like most diseases, prevention is better than cure, here are the options to consider:

  • Avoid alcohol
  • Lose weight
  • Consume medications to control cholesterol and triglycerides
  • Consume vitamin E
  • Take medication for diabetes type 2
  • Exercise regularly

Frequently asked questions

Is fatty liver fatal?
Fatty liver disease does not usually cause symptoms in the first three stages, and these three stages are reversible. Meaning if various lifestyle changes are implemented, you can reverse your fatty liver disease. However, if your fatty liver disease is left untreated and progresses to liver cirrhosis, it can lead to liver failure and death.
Is ginger good for fatty liver?
Ginger has been shown to reduce inflammation, cholesterol, and triglycerides which are all key factors of fatty liver disease.
What is the fastest way to cure fatty liver?
Studies have shown that losing weight via exercise and diet has shown significant cure rates of fatty liver.

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