Non-alcoholic Steatohepatitis (NASH)
Non-alcoholic steatohepatitis (NASH) is an advanced form of non-alcoholic fatty liver disease (NAFLD). NAFLD is caused by buildup of fat in the liver. When this buildup causes inflammation and damage, it is known as NASH, which can lead to scarring of the liver. Scarring of the liver is a potentially life-threatening condition called cirrhosis
There are often no outward signs or symptoms associated with NASH. The most common symptoms are:
- Pain in the upper right abdomen (usually mild)
NASH may lead to cirrhosis of the liver, causing one or more of the following symptoms as the condition progresses:
- Bleeding easily
- Bruising easily
- Itchy skin
- Yellow discoloration in the skin and eyes (jaundice)
- Fluid accumulation in your abdomen
- Loss of appetite
- Swelling in your legs
- Slurred speech
- Spider-like blood vessels on your skin
Causes and Risk Factors
NASH is most common in patients who are overweight or obese.
Other risk factors include:
- High cholesterol
- High triglycerides
- Poor diet
- Metabolic syndrome
- Polycystic ovary syndrome
- Sleep apnea
- Underactive thyroid (hypothyroidism)
The Cedars-Sinai Fatty Liver Program uses the most advanced diagnostic technology available and continues to investigate new ways to identify the NAFLD and NASH.
Diagnosis generally begins with a physical exam and a review of the patient’s medical history. If NAFLD or NASH are suspected, blood tests will be done to determine how the liver is working. Imaging tools, such as magnetic resonance imaging (MRI), or ultrasound may also be used to help.
If NASH is suspected, the patient will undergo a liver biopsy. During this procedure, a needle is used to remove a small piece of tissue from the liver, which will then be examined under a microscope. This allows the physician to determine if any scarring or inflammation of the liver tissue has occurred. Patients are usually sedated during the liver biopsy.
The Fatty Liver Program also uses special MRI technology, called MR-EFF (elastography fat fraction), to determine the percentage of fat and scarring present. This non-invasive diagnostic tool may eliminate the need for a liver biopsy.
The knowledgeable and highly trained experts in the Fatty Liver Program are dedicated to providing each patient with the best possible treatment.
While there is no standard treatment for patients NASH, lifestyle changes have been shown to affect its progression. This may include losing weight, maintaining a healthy diet, or addressing underlying conditions such as hypothyroidism and diabetes.
The Fatty Liver Program takes an integrated approach to treatment, combining nutritional and lifestyle expertise and support with access to the latest clinical trials and research.
It is important for patients with NASH to avoid consuming excessive alcohol as this can contribute to the condition.
Cedars-Sinai has a range of comprehensive treatment options.