Dr Kieron Lim
Senior Consultant Gastroenterologist
MBBS (University of London), MRCP (UK), FRCP (Edinburgh), FAMS (Gastroenterology)
The liver is a vital organ responsible for metabolism, detoxification, and nutrient storage. However, like other organs, the liver is susceptible to various conditions, particularly fatty liver disease. This condition, also called hepatic steatosis, occurs when fat builds up in liver cells, leading to inflammation and damage.
Fatty liver disease is classified into two major types based on its causes: alcoholic fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD). Both conditions share a common characteristic of fat accumulation but differ significantly in their causes and progression.
Alcoholic Fatty Liver Disease (AFLD)
AFLD is primarily caused by excessive alcohol consumption, leading to fat accumulation in liver cells. Chronic alcohol intake disrupts the liver's metabolic processes, resulting in fat deposition.
Symptoms of AFLD
Symptoms of AFLD may not be noticeable in its early stages until the liver has sustained significant damage. When this happens, some individuals may experience:
Fatigue
Weakness
Discomfort in the upper right abdomen
Diarrhoea
Loss of appetite
Weight loss
Progression of AFLD
If ignored or left untreated, AFLD can lead to more severe liver conditions, such as:
Alcoholic Hepatitis
: This condition is a more severe form of liver inflammation that can lead to liver failure.Fibrosis
: This occurs when excessive scar tissue forms in the liver due to chronic or repeated liver injury.Cirrhosis
: This involves irreversible scarring of the liver and significant impairment of liver function.
Non-Alcoholic Fatty Liver Disease (NAFLD)
NAFLD refers to the build-up of excess fat in liver cells not caused by alcohol, but rather by metabolic factors.
Causes of NAFLD
NAFLD typically develops in individuals with:
Obesity
: An excessive amount of fat, especially around the belly, causes the liver to store extra fat.Type 2 Diabetes
: Having type 2 diabetes may increase the risk of developing NAFLD due to shared metabolic pathways and insulin resistance.Hyperlipidaemia
: High cholesterol levels contribute to NAFLD by increasing the amount of fat metabolised by the liver, particularly LDL cholesterol.Sedentary Lifestyle
: Lifestyle factors, including a diet high in saturated fats and sugars, lack of physical activity, and poor nutrition, contribute to NAFLD.
Symptoms of NAFLD
Like AFLD, NAFLD is often asymptomatic in its early stages. As the disease progresses, individuals may experience:
Fatigue
Unexpected weight loss
Weakness
Mild discomfort in the upper right abdomen
Progression of NAFLD
The progression of NAFLD is slow and varies among individuals. While some may only experience simple fatty liver, others may develop severe liver conditions, such as:
Non-Alcoholic Steatohepatitis (NASH)
: This is a severe form of NAFLD where liver damage and inflammation are present along with fat accumulation.Cirrhosis
: This refers to advanced liver scarring caused by long-term liver damage.Liver Cancer
: The buildup of fat in the liver can cause inflammation and chronic liver disease, eventually leading to cirrhosis, a significant risk factor for liver cancer (hepatocellular carcinoma).
Comparative Overview: AFLD vs. NAFLD
While AFLD and NAFLD both involve fat accumulation in the liver, they differ significantly in
their causes, risk factors, and progression.
The following table provides a comparative overview of AFLD and NAFLD:
AFLD (Alcoholic Fatty Liver Disease)
- Primary Cause: Excessive alcohol consumption
- Alcohol Intake: Significant
- Risk Factors: Heavy drinking, genetic predisposition
- Progression Risk: High with continued alcohol use
- Management: Abstinence from alcohol, nutritional support
NAFLD (Non-Alcoholic Fatty Liver Disease)
- Primary Cause: Metabolic factors (e.g., obesity, diabetes)
- Alcohol Intake: Minimal to none
- Risk Factors: Obesity, insulin resistance, high cholesterol
- Progression Risk: High with unmanaged metabolic syndrome
- Management: Weight loss, dietary changes, increased physical activity
Prevalence in Singapore
Liver diseases, including AFLD and NAFLD, are significant health concerns in Singapore. Liver cancer was the fifth most common cancer among males from 2017 to 2021, with 2,984 cases reported, according to the Ministry of Health.
Knowing the differences between alcoholic (AFLD) and non-alcoholic fatty liver disease (NAFLD) is vital for their effective prevention and management. AFLD is directly linked to alcohol consumption, whereas NAFLD is associated with metabolic factors. Despite their differing causes, both conditions can lead to severe liver complications if left untreated.
Regular medical check-ups, alongside lifestyle modifications and early interventions, are crucial for preventing the progression of fatty liver disease and ensuring better liver health outcomes.
Meet Our Specialist
Dr Kieron Lim
MBBS, University of LondonMember, Royal College of Physicians (UK)Fellow, Academy of Medicine (Gastroenterology) SingaporeFellow, Royal College of Physicians (Edinburgh)
Dr Kieron Lim is a senior consultant specialising in Gastroenterology and Hepatology, providing comprehensive care for patients with gastrointestinal conditions in Singapore. His expertise extends to disorders affecting the oesophagus, stomach, colon, liver, pancreas, and gallbladder. Through his experience, Dr Lim enhances patient outcomes by facilitating early detection and timely medical interventions.
Location
Mount Elizabeth Medical Centre
3 Mount Elizabeth #10-02Singapore 228510
Contact Us
Whatsapp: (65) 9726 0495 | Telephone: (65) 6836 0080
Fax: (65) 6836 0090 | Emergency: (65) 6533 0088
Email: enquiries@kieronlimgastro.sg