Non-Alcoholic Steatohepatitis

What is Nonalcoholic Steatohepatitis (NASH)?

Nonalcoholic steatohepatitis (NASH) is a type of fatty liver disease. It develops when too much fat accumulates in the liver, a condition called fatty liver. Although NASH is similar to alcoholic liver disease, which is caused by drinking too much alcohol, it’s not the same. You don’t have to drink alcohol to get NASH.

It’s estimated that 3 to 12 percent of adults in the United States have NASH, although exact numbers are uncertain, because it’s often difficult to diagnose. The good news is that NASH can be successfully managed with lifestyle changes and medications.

What Are the Symptoms of NASH?

Most cases of NASH don’t cause noticeable symptoms. Even if you have a more advanced case, you might not feel any physical signs. When symptoms do occur, they may include:

  • Fatigue
  • Weakness or pain in your upper right abdomen
  • Weight gain
  • Nausea
  • Jaundice (yellowing of the skin or eyes)

What Causes NASH?

The exact cause of NASH is unknown, but it’s suspected that it’s related to obesity and diet. In people with NASH, insulin resistance — a condition where the body’s cells don’t respond normally to insulin — is common. Insulin resistance is considered an independent risk factor for NASH.

Diagnosing NASH

If your doctor suspects NASH, they’ll ask questions about your medical history and do a physical exam. They might also recommend one or more of these tests:

  • Blood tests. High liver enzymes normally indicate liver damage.
  • Imaging tests. These tests can help doctors see the inside of your body and spot signs of inflammation.
  • Liver biopsy. This is the most definitive way to diagnose NASH. During a liver biopsy, a needle is inserted through your skin to remove a small sample of your liver. The sample is then tested in a lab to check for damage.

Treatment Options for NASH

The goal of NASH treatment is to reduce fat in your liver and improve how it functions. Treatment may include:

  • Medications. These might number medications help reduce liver inflammation and decrease your risk of developing complications.
  • Lifestyle changes. These are often a recommended treatment for NASH. Eating healthy, exercising, and losing weight can all help to reduce fat and improve liver function.

If you’ve been diagnosed with NASH, talk to your doctor about your treatment options and how to best manage your condition.