A non-alcoholic Steatohepatitis is an advanced form of NAFLD – non-alcoholic fatty liver disease. It’s caused by the build-up of fat in the liver cells and causes inflammation. Not treated on time can lead to liver scarring and fibrosis. Liver scarring can lead to a life-threatening condition, cirrhosis.
If the inflammation continues over a long period, it can lead to irreversible liver damage. NASH is often associated with obesity, type 2 diabetes, and high lipid levels in the blood as the common risk factors.
To learn more about the common symptoms of NASH, and how it can be diagnosed and prevented, check out this article.
Non-Alcoholic Steatohepatitis
So what is NASH? NASH is the excess of fats stored in the liver cells. For the majority of people, the condition doesn’t cause any problems; however, when it does, it’s often referred to as steatohepatitis.
The term hepatitis refers to liver inflammation, and “steato” means fat.
Chronic liver inflammation can lead to scarring of the liver tissues and potentially to liver failure.
Liver failure occurs when the liver doesn’t work properly to perform its functions, like eliminating toxic substances from the body, making blood proteins, storing glucose, breaking down saturated fat, and manufacturing bile. The symptoms of liver failure include blood in the stool, loss of appetite, and nausea.
NASH is commonly associated with heavy alcohol use; nevertheless, most people get this condition despite their low alcohol consumption.
Symptoms
In the early stages of non-alcoholic fatty liver diseases, most people display a certain range of symptoms. The most common ones are an ache in the upper right abdomen, unexplained weight loss, fatigue and weakness, and loss of appetite.
The more advanced stages are characterized with:
- Jaundice – yellowing of the whites of the eyes and the skin;
- Ascites – inflamed and swollen abdomen;
- Edema – swelling in the feet and legs;
- Spider-like blood vessels under the skin;
- Portal hypertension – can cause intestinal bleeding;
- Pruritus – persistent itching;
- Enlarged spleen or enlarged liver;
- Hepatic encephalopathy – drowsiness, confusion;
- Red palms
- Fatigue
- Patches of discolored skin under the arms or on the neck;
- Enlarged abdomen
Common Causes
High levels of fats in the blood are one of the main factors in developing NASH, and researchers are still not certain about the extent to which this contributes to liver damage. Additional risk factors include being overweight (a BMI of 25+), underactive pituitary gland, underactive thyroid, high blood sugar, and blood pressure, type 2 diabetes, insulin resistance, metabolic syndrome, postmenopause, PCOS, and rapid weight loss.
If some of the health problems above are combined, it can promote fat deposits in the liver. For some people, the excess liver fats can be a toxin and cause a more progressive form of the disease.
People that belong to the following groups have higher chances of developing NASH:
- People with PCOS and diabetes type 2;
- Older people;
- People who have most of the body fat in the abdomen;
Diagnosis
People with non-alcoholic steatohepatitis do not experience any symptoms in the early phases and recognize the signs during a routine blood test or screening for other conditions. The disease displays a wide range of abnormalities in the test results, like high levels of aspartate aminotransferase and alanine aminotransferase.
However, the blood tests do not show any residue of scarring tissue or the extent of liver damage. Thus, an additional workup plan is required.
NASH can be diagnosed via various methods. Healthcare providers will order tests and scans if they suspect you have non-alcoholic steatohepatitis. The tests are:
- Liver function test – check the extent of liver inflammation;
- A lipid panel;
- Abdominal ultrasound;
- A CT scan;
- A fibroscan – a special type of ultrasound that measures the liver fat and scar tissue;
- Liver biopsy – determine the extent of the disease and exclude malignancy.
Prevention
If you don’t have NASH, you may be able to prevent it by maintaining a healthy weight, limiting portion sizes, exercising regularly, and eating a balanced diet. If you are overweight or struggling with obesity, your doctor may recommend you lose weight gradually.
Changes to your diet, like replacing saturated fats with unsaturated ones, limiting the intake of fats, increasing the intake of omega-3 fatty acids, and avoiding foods that contain high levels of fructose and sugars, are very helpful.
Treatment
Regarding the treatment of non-alcoholic steatohepatitis, there are no medications that can make the disease reversible. However, lifestyle modifications and a balanced diet are the main methods for treating NASH.
Losing up to 10% of the body weight will reduce the fat levels and the inflammation in the liver. And if you have diabetes, it’s important to monitor your sugar levels and take the prescribed medications as instructed by your healthcare provider.
Another helpful tip to have in mind is to try out the Mediterranean diet. This type of diet is enriched with plant-based foods like potatoes, vegetables, beans, whole grains, seeds, nuts, and extra virgin olive oil and can reduce heart problems by 30%.
Some studies include coffee as a helpful factor in preventing fibrosis. According to researchers, two cups per day is enough, but you have to tolerate caffeine.
What’s The Outlook?
A person with non-alcoholic steatohepatitis already has a high percentage of fats in the liver, which makes it swollen and scarring. In certain people, the disease will develop beyond the early stages and, if not treated on time and properly, can lead to cirrhosis.
At the cirrhosis stage, the damage becomes permanent, inhibiting the liver from normal functioning. A small percentage of people will develop liver cancer. Nevertheless, in either case, a transplantation of the liver might be required.
While there are no current medications for curing NASH, proper self-care and lifestyle changes can help you manage the disease and live symptom-free. So, make sure you follow your physician’s recommendations!
See A Doctor
Make an appointment if you notice any of the symptoms and signs above. Take care of your health, and make sure to go to regular check-ups!
