Nonalcoholic Steatohepatitis (NASH) 

Nonalcoholic fatty liver disease occurs due to a buildup of fat in the liver. When inflammation and damage happen due to this fat buildup, it becomes nonalcoholic steatohepatitis (NASH). If left untreated, NASH can lead to scarring of the liver (cirrhosis), which can become life-threatening.  

Causes of Nonalcoholic Steatohepatitis 

The biggest risk factor associated with nonalcoholic steatohepatitis is being overweight. Other factors that put someone at higher risk include: 

• Diabetes 
• High cholesterol 
• High triglycerides 
• Poor diet 
• Metabolic syndrome 
• Polycystic ovary syndrome 
• Sleep apnea 
• Underactive thyroid (hypothyroidism) 

Symptoms of Nonalcoholic Steatohepatitis 

There aren’t many noticeable symptoms of nonalcoholic steatohepatitis, but the two most common ones include fatigue and pain in the upper right abdomen. However, if the NASH leads to cirrhosis, it could cause the following symptoms: 

• Bleeding or bruising easily 
• Itchy skin 
• Yellow discoloration in your skin and eyes (jaundice) 
• Fluid accumulation in your abdomen 
• Loss of appetite 
• Nausea 
• Swelling in your legs 
• Confusion 
• Drowsiness 
• Slurred speech 
• Spider-like blood vessels in your skin 

Diagnosis of Nonalcoholic Steatohepatitis 

Diagnosis generally begins with a physical exam and a review of the patient’s medical history. If nonalcoholic fatty liver disease or nonalcoholic steatohepatitis is suspected, certain tests may be performed, such as: 

• Blood tests 
• Imaging tests like MRIs and ultrasounds 
• A liver biopsy 

Treatment of Nonalcoholic Steatohepatitis 

There is currently no standard treatment for patients with NASH, but lifestyle changes have been shown to affect its progression. Types of changes may include: 

• Losing weight 
• Maintaining a healthy diet
• Addressing underlying conditions  

If the nonalcoholic steatohepatitis leads to severe cirrhosis, liver transplantation may be an option.