Fatty liver disease has become one of the most common liver-related conditions in Singapore, largely due to rising rates of obesity, diabetes and sedentary lifestyles. In many cases, the condition progresses silently until more serious liver damage has occurred.
This article explains when individuals should consult a liver specialist, how the condition is diagnosed and why early assessment can help prevent complications such as cirrhosis or liver cancer.
What Is Fatty Liver Disease?
Fatty liver disease, or hepatic steatosis, occurs when there is excess fat in the liver. There are two main types:
- Alcohol-related fatty liver disease (ARLD) – due to excessive alcohol consumption
- Non-alcoholic fatty liver disease (NAFLD) – seen in people who drink little or no alcohol
NAFLD can range from simple steatosis (fat accumulation with no inflammation) to non-alcoholic steatohepatitis (NASH), which involves inflammation and may lead to fibrosis and cirrhosis.
When Should You See a Liver Specialist?
You should consider consulting a hepatologist or liver specialist in Singapore if:
1. You Have Metabolic Risk Factors
If you have obesity, type 2 diabetes, high cholesterol or hypertension, your risk of NAFLD is higher. These conditions often go hand-in-hand with fatty liver disease, even in the absence of symptoms.
2. Your Liver Function Tests Are Abnormal
Routine blood tests may show elevated liver enzymes (ALT, AST). While this doesn’t confirm fatty liver, it warrants further evaluation with imaging or FibroScan to assess for fibrosis or inflammation.
3. You Have Fatty Liver on Ultrasound
An ultrasound finding of fatty liver, especially when combined with risk factors or abnormal blood tests, is an indication to consult a liver specialist. The goal is to determine if there’s progression to NASH or fibrosis.
4. You Experience Symptoms Suggesting Progression
Although early fatty liver is usually asymptomatic, signs such as fatigue, discomfort in the right upper abdomen and unexplained weight changes may suggest a more serious disease. These symptoms should not be ignored.
How Is Fatty Liver Diagnosed?
Specialists use a combination of clinical risk scoring, blood tests and imaging:
- Liver enzymes to detect inflammation
- Ultrasound to visualise liver fat
- Transient elastography (FibroScan) to evaluate liver stiffness and fibrosis
- MRI or biopsy, if further clarification is needed
At kieronlimgastro.com.sg, Dr Kieron Lim explains that accurate staging of liver disease helps guide treatment decisions and prevent long-term liver damage.
Why Early Referral Matters
If left unchecked, NAFLD can progress to:
- Non-alcoholic steatohepatitis (NASH)
- Liver fibrosis and cirrhosis
- Liver cancer (hepatocellular carcinoma)
- End-stage liver failure, which may require transplantation
Dr Kieron Lim, gastroenterologist at Mount Elizabeth Medical Centre, stresses that early intervention through weight loss, metabolic control and ongoing monitoring can reduce progression.
At his clinic, he provides comprehensive evaluation and management for patients with fatty liver and cirrhosis, including FibroScan and endoscopic assessments where appropriate.
What to Expect at a Specialist Appointment
During your visit, a liver specialist may:
- Review your medical history, blood pressure, BMI and blood test results
- Order further investigations like a FibroScan or liver MRI
- Discuss lifestyle modification plans, including weight loss and dietary changes
- Recommend regular monitoring intervals depending on your risk level
Final Thoughts
Fatty liver disease often develops silently, but in individuals with metabolic risk factors or abnormal liver tests, early evaluation is crucial. Seeing a liver specialist allows for personalised assessment and guidance to reduce the risk of long-term liver damage.
In Singapore, specialists like Dr Kieron Lim provide comprehensive assessment and ongoing care for patients with fatty liver disease, cirrhosis, viral hepatitis and transplant-related conditions—helping them preserve liver function and quality of life.
