Liver Clinic

The Liver Clinic will provide diagnosis and management of all acute and chronic liver diseases including hepatitis, fatty liver, cirrhosis and cancer. Different specialities led by our team of certified hepatologists, are ably supported by Dr Rajesh Nambiar, Liver Surgeon. They will collaborate closely with each specialist in order to tailor a care plan for every patient’s specific need. For more complex cases, they will meet together to pool their expertise to arrive at the best approach to your treatment.

Our services:

• Counselling and education about liver problems so patients understand their infections and their treatment options. This includes lifestyle and behaviour modifications supported by nutrition counselling and an on-site pharmacy.
• Liver assessments and treatments using a combination of blood and lab work, imaging, and other diagnostic tools such as ultrasound, to determine each patient’s condition and choose a course of treatment. Imaging sometimes includes Fibroscan®, a liver scan, used to determine the stage of liver disease.
• Follow-up of post liver transplant patients
• Vaccinations 

Are you at risk of developing liver problems?

Liver disease is known as a silent killer and most often the patients do not show any symptoms until the problems are already severe. That is why it is important to check with your hepatologist regularly, in order to determine the issue and prevent it from progressing.

Factors that may increase your risk of liver disease include:

• Heavy alcohol or substance abuse
• Obesity
• Diabetes
• Hypertension
• Hyperlipidemia
• Family history of liver disease or cancer
• Exposure to viruses
• Long term medications
• Other diseases which can affect the liver like arthritis, inflammatory bowel disease, etc.

Symptoms of liver disease:

The signs and symptoms of liver disease include:

• Appearance of yellowish shade under the eyes
• Skin turning yellowish
• Swelling in the abdomen accompanied with pain
• Visible swelling on ankles and legs
• Itchy skin
• Dark-coloured urine
• Pale, tar-coloured or bloody stools
• Fatigue
• Constant vomiting or nausea
• Significant loss of appetite
• Easy bruising

Non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) is a spectrum of liver disease characterised by the presence of extra fat in the liver, steatosis, which cannot be explained by alcohol consumption or drugs.

Stages of non-alcoholic fatty liver disease (NAFLD)

NAFLD develops in four main stages.

Most people will only ever develop the first stage, usually without realising it.

In a small number of cases, it can progress and eventually lead to liver damage if not detected and managed.

The main stages of NAFLD are:

• simple fatty liver (steatosis) – a largely harmless build-up of fat in the liver cells that may only be diagnosed during tests carried out for another reason
• non-alcoholic steatohepatitis (NASH) – a more serious form of NAFLD, where the liver has become inflamed
• fibrosis – where persistent inflammation causes scar tissue around the liver and nearby blood vessels, but the liver is still able to function normally
• cirrhosis – the most severe stage, occurring after years of inflammation, where the liver shrinks and becomes scarred and lumpy; this damage is permanent and can lead to liver failure (where your liver stops working properly) and liver cancer

It can take years for fibrosis or cirrhosis to develop. It's important to make lifestyle changes to prevent the condition getting worse.

Am I at risk of non-alcoholic fatty liver disease (NAFLD)?

You're at an increased risk of NAFLD if you:

• are obese or overweight – particularly if you have a lot of fat around your waist (an "apple-like" body shape)
• have type 2 diabetes
• have a condition that affects how your body uses insulin
• are insulin resistance, such as polycystic ovary syndrome
• have an underactive thyroid
• have high blood pressure
• have high cholesterol
• have metabolic syndrome (a combination of diabetes, high blood pressure and obesity)
• are over the age of 50
• smoke

But NAFLD has been diagnosed in people without any of these risk factors, including young children.

Although it's very similar to alcohol-related liver disease (ARLD), NAFLD is not caused by drinking too much alcohol.

Symptoms of non-alcoholic fatty liver disease (NAFLD)

There are not usually any symptoms of NAFLD in the early stages. You probably will not know you have it unless it's diagnosed during tests carried out for another reason.

Occasionally, people with NASH or fibrosis (more advanced stages of NAFLD) may experience:

• a dull or aching pain in the top right of the tummy (over the lower right side of the ribs)
• extreme tiredness
• unexplained weight loss
• weakness

If cirrhosis (the most advanced stage) develops, you can get more severe symptoms, such as yellowing of the skin and the whites of the eyes (jaundice), itchy skin, and swelling in the legs, ankles, feet or tummy (oedema).

For appointments and other information, call 800 1999