Understanding Nonalcoholic Steatohepatitis (NASH) – A Guide to Symptoms

Nonalcoholic steatohepatitis (NASH) is a severe form of nonalcoholic fatty liver disease (NAFLD) that involves both excess fat and inflammation in the liver. This condition can lead to cell damage, affecting the liver’s normal function and potentially causing cirrhosis, a condition characterized by liver scarring. However, not everyone with NASH develops cirrhosis.

Causes of NASH are not fully understood, but individuals with certain medical conditions are more prone to this type of fatty liver disease. These conditions include higher body weight, type 2 diabetes, and metabolic issues such as high cholesterol, high triglycerides, and insulin resistance. Some medications, like steroids or certain drugs for cancer or abnormal heart rhythms, have also been linked to NASH.

NASH can affect people of any age, including children, but it is most commonly diagnosed in individuals between 40 and 60 years old. Females tend to be more affected than males, and NASH is a leading reason why women may require a liver transplant. Additionally, it appears to be more prevalent among Mexican American or Hispanic populations compared to other racial and ethnic groups.

Around 1.5% to 6% of U.S. adults may have NASH, accounting for approximately 20% of all NAFLD cases. It’s essential to differentiate between NASH and simple fatty liver, where fat buildup occurs in the liver without inflammation or significant cell damage.

Recognizing the symptoms of NASH can be challenging, as most people don’t experience any noticeable signs. However, some individuals with NASH may feel tired or have a mild ache in the upper right part of their belly. Severe liver damage can lead to easy bleeding or bruising, weakness, and jaundice (yellowing of the skin).

Diagnosing NASH typically involves routine blood tests to check for signs of liver damage, followed by further tests such as ultrasound, CT scan, or MRI to identify fat accumulation in the liver. A biopsy may be performed to pinpoint inflammation and damage caused by NASH.

Unfortunately, there are currently no approved drugs specifically designed to treat or cure NASH. However, managing underlying health conditions that may harm the liver, such as high blood sugar or high cholesterol, can help. Lifestyle changes play a crucial role in stopping or even reversing NASH. These changes may include weight loss, regular exercise, and adopting a nutrient-rich diet that includes fruits, vegetables, whole grains, and healthy fats.

For weight loss, a gradual reduction of 3% to 5% of body weight can help decrease fat in the liver, while a more substantial loss of 7% to 10% can lower inflammation and scarring caused by NASH. Engaging in regular aerobic exercises for at least 150 minutes a week, regardless of weight loss, can protect the liver from damage.

A healthy diet, such as the Mediterranean diet, which includes more fruits, vegetables, whole grains, and unsaturated fats like those found in olive oil and fish, is recommended. Reducing sugar and saturated fat intake from drinks and snacks can further support liver health. If unsure about dietary choices, seeking guidance from a dietitian can be beneficial.

Managing NASH requires a comprehensive approach involving medical supervision, lifestyle modifications, and proper monitoring. By taking these steps, individuals can better manage the impact of NASH on their liver health and overall well-being.