Health Check for Fatty Liver Disease

Dr. CHAN On On, Annie

Director, Gastroenterology & Hepatology Centre

Honorary Consultant in Gastro-Enterology

Honorary Consultant in Hepatology

Specialist in Gastroenterology & Hepatology

Now an emerging health concern worldwide, fatty liver disease is characterised by fat accumulation in the liver, which can progress to liver dysfunction and even liver failure.

Symptoms and Risk Factors

There are two major types of fatty liver disease, i.e. Non-alcoholic Fatty Liver Disease (NAFLD) and alcoholic fatty liver disease. NAFLD is the most common cause of chronic liver disease. Its increasing incidence is associated with metabolic risk factors such as obesity, insulin resistance, diabetes and dyslipidaemia attributed to pre-disposing genetic factors as well as Western dietary and lifestyle habits. On the other hand, alcoholic fatty liver disease is caused by excessive alcohol consumption, of which the duration and amount of alcohol are directly associated with the risk of significant alcohol-related liver damage, especially in females.

Fatty liver disease may progress differently from person to person. At the early stage (steatosis), it could be mere fatty liver without symptoms. In case of fatty liver with hepatic inflammation (steatohepatitis), patients may experience fatigue, abdominal discomfort and jaundice. Fibrosis then develops if inflammation persists. Liver cirrhosis ensues in advanced cases, leading to pedal edema and ascites. It is often accompanied by a higher likelihood of liver failure and liver cancer.

Fortunately, fatty liver disease is largely preventable and treatable through lifestyle modifications and regular check-ups. The keys to maintaining an ideal weight are a low-cholesterol and high-fibre diet, less  consumption of processed and sugary foods and limited alcohol intake, i.e. female < 1 portion/day; male < 2 portions/day¹. Active management of diabetes and other metabolic conditions is also crucial to reducing the risk of developing fatty liver disease.

Screening and Diagnosis

Regular check-ups can help detect fatty liver disease in its early stages when it is more easily treatable. Blood tests (e.g. liver function test), imaging studies (e.g. ultrasound, FibroScan) and liver biopsies may be performed to diagnose and monitor fatty liver disease.

In particular, FibroScan is a non-invasive transient elastography that uses ultrasound to assess and provide quantitative measurements of fat content and degree of liver fibrosis of the liver. As  a low-risk and painless alternative to liver biopsy, it is especially useful in diagnosing and monitoring disease progression and treatment response of chronic liver diseases, including hepatitis B or C, NAFLD, alcoholic fatty liver disease, liver fibrosis and cirrhosis. It is also a standard test for patients suspected of   fatty liver and liver fibrosis, and can facilitate early detection of high-risk patients with liver-related complications and management of liver diseases.

In conclusion, despite its devastating health impacts, fatty liver disease is preventable and manageable through lifestyle modifications and regular check-ups. Try to maintain a healthy lifestyle and seek medical attention if you experience any symptoms or risk factors of fatty liver disease.

Remarks:

1. 1 portion of alcohol is equivalent to 1 cup (5oz) of red or white wine; or 1 can (12oz) of beer (about 330-355ml); or 1.5oz liquor.