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Fatty Liver Disease

Dr. John Hsiang, Senior Consultant Gastroenterologist

richmond conditions image (31)
richmond conditions image (30)

What is Fatty Liver Disease?

Fatty liver disease, also known as hepatic steatosis, is a condition in which fat builds up in the liver. It is a common condition in Singapore, affecting about 1 in 4 adults.

Symptoms of Fatty Liver Disease:

Fatty liver disease often does not cause any symptoms in the early stages. However, as the disease progresses, people may experience:

What are the Types of Fatty Liver Disease?

There are two main types of fatty liver disease:


  • Non-alcoholic fatty liver disease (NAFLD): This is the most common type of fatty liver disease and is not caused by alcohol. NAFLD is often associated with other health conditions such as obesity, type 2 diabetes, and metabolic syndrome.


  • Alcoholic fatty liver disease (AFLD): This type of fatty liver disease is caused by excessive and heavy alcohol consumption.

How does Fatty Liver Disease Happen?

The liver plays an important role in breaking down fats and other nutrients from the food we eat.

When we eat more calories than we need, the excess is stored as fat in the liver. Over time, this can lead to fatty liver disease.

What are the complications of fatty liver disease?

If left untreated, fatty liver disease can lead to serious complications, including:

How is Fatty Liver Disease Diagnosed?

Fatty liver disease can be diagnosed with a variety of tests, including:

  • Blood tests: These tests can measure the levels of liver enzymes in the blood. High levels of liver enzymes may be a sign of fatty liver disease.

  • Imaging tests: Imaging tests such as ultrasound, CT scan, or MRI can be used to visualize the liver and look for signs of fat accumulation.

  • Bedside Fibroscan: This test measures the amount of fat in the liver and excludes liver scarring with the examination.

  • Liver biopsy: A liver biopsy is a procedure where a small sample of liver tissue is removed and examined under a microscope. This is the most definitive way to diagnose fatty liver disease.

How is Fatty Liver Disease Treated?

Treatment focuses on addressing the underlying causes of the disease, such as obesity, type 2 diabetes, and high cholesterol. Lifestyle changes such as weight loss, exercise, and a healthy diet are also important in managing fatty liver disease.

Most important lifestyle changes includes avoidance of fructose consumption, regular moderate intensity cardio-exercises at least 140 minutes per week, whilst achieving heart rate >120-140 per minutes. Increase intake of polypunsaturated fatty acid and caffeine can improve liver inflammation as well. 

In some cases, medication may be prescribed to help control the disease and prevent complications. Medications such as vitamin E and GLP-1 agonist may be used to treat NAFLD. 

Improvement in non-alcoholic fatty liver disease can be see when the patient loses 7-10% of body weight.

In patients with mild alcoholic liver disease, cutting down alcohol to a weekly amount below 14 units is recommended. Sometimes, total abstinence from alcohol is recommended in those with severe alcoholic liver disease.

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About Dr. John Hsiang

MBChB (NZ), FRACP (Australasia), MD (Doctorate), FRCP (Edinburgh), FAMS (Gastro)

Dr. John Hsiang is a Gastroenterologist and Hepatologist with more than 20 years of clinical experience in public and private practice.

Dr. John’s special clinical interests are gastroesophageal reflux disease, stomach conditions, fatty liver, and gastrointestinal cancer screening

Dr. John has spent more than five years in the Singhealth cluster serving in the Gastroenterology Department at Changi General Hospital and Sengkang General Hospital.

Clinical interests:

Indigestion, gastroesophageal reflux disease, helicobacter pylori infection, irritable bowel syndrome, constipation, diarrhoea, hepatitis B, fatty liver disease, management of abnormal liver tests.

Dedicated Insurance Support

We understand that navigating the financial aspect of healthcare can be overwhelming. We welcome all patients with or without insurance and can assist with claims regardless of your personal or corporate insurance plan.

Here at Richmond Gastroenterology Centre, we strive to ensure the most efficient claims process for our patients. To that end, our team works diligently with their insurers to obtain Letters of Guarantee and pre-authorization certificates prior to any procedures.

Make an appointment to consult our Doctor.

We understand your anxieties and we are here to support you throughout your health journey. If you have questions or would like to seek a 2nd opinion, send us your message via the form below.

To get an immediate response, you may also call us at: 6517 9958

Dr. John Hsiang is an Accredited Specialist Across All Private Hospitals in Singapore.