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    Fatty Liver

    Where to Seek Treatment
    Singapore General Hospital
    Contributed by Centre for Digestive and Liver Diseases (CDLD)
    Fatty liver is a common chronic liver disease and can be treated by lifestyle modifications.


    Non-Alcoholic Fatty Liver Disease (NAFLD) is a common chronic liver disease when excess fat is deposited in the liver of people who drink little or no alcohol. It can range from “good fat” or simple fat to “bad fat” or Nonalcoholic Steatohepatitis (NASH). NASH can lead to liver cirrhosis and liver cancer.

    Obesity may be a cause of fatty liver.Causes

    • Diabetes
    • Obesity (BMI>25 kg/m2 in Asian people)
    • Increased belly fat (Central obesity) »» waistline >90cm in Asian men or >80cm Asian women
    • Cholesterol problems
    • Hypertension
    • Metabolic syndrome
    • Other associated conditions like Obstructive Sleep Apnea (OSA), Polycystic Ovary Syndrome (PCOS), Underactive Thyroid (Hypothyroidism), Underactive Pituitary (Hypopituitary)


    NAFLD usually does not cause symptoms. If symptoms are present, it may be non-specific type symptoms of tiredness, nausea and discomfort over the right upper abdomen. However, if NAFLD progress to cirrhosis, signs and symptoms of cirrhosis may appear.


    NAFLD is diagnosed by a combination of history, physical examination, blood tests and imaging studies of the liver.

    • Liver function tests such as liver enzymes (ALT, AST) may be elevated
    • Ultrasound, CT or MRI scan may show fatty liver
    • Other blood tests may be needed to predict severity of disease or exclude other liver diseases
    • Liver biopsy may be required to stage the disease


    Treatments may include:

    Lifestyle modifications

    • Weight loss
    • Diet
    • Exercise

    Treatment of associated factors

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

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