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What is Non-Alcoholic Steatohepatitis (NASH)?

Nonalcoholic steatohepatitis (NASH) is part of a group of conditions called nonalcoholic fatty liver disease (NAFLD), which damages the liver due to a buildup of fat. NASH differs from non-alcoholic fatty liver disease and is characterized by a type of liver cell injury, called hepatocellular ballooning, and inflammation.

NASH, sometimes referred to as steatohepatitis or just hepatitis, progresses over time with inflammation that can damage liver cells, which in turn leads to fibrosis and scarring. Excessive scarring in the liver is a natural response to injury and if left untreated progress to cirrhosis, and an increased risk of liver cancer.

Who is at risk?

Most patients live with NASH for several years without experiencing any symptoms and are mostly unaware of their liver condition.  It is observed in individuals who chronically consume a high-fat, high calorie diet and have a sedentary lifestyle in the absence of significant alcohol consumption. Excess calories are stored in liver cells as lipids, or fat. If the liver contains more than 5 percent of fat and looks pale yellow it is considered fatty liver disease.

NASH occurs most often in patients between 40 and 60 years but can occur in all age groups. It is more common in people with obesity, type 2 diabetes, or glucose intolerance, dyslipidemia, and/or metabolic syndrome, which is a cluster of conditions characterized by increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels.

Experts estimate that about 20 percent of people with NAFLD have NASH. Why some people with NAFLD have NASH and others don’t is unknown.

NASH is heavily influenced by lifestyle (e.g. chronic excessive calorie intake, sedentary activity) and is distinct from other fatty liver diseases caused by alcohol abuse or medication side effects.

Symptoms and signs of nonalcoholic steatohepatitis (NASH)

You may have no symptoms in the early stages of NASH. Most people who have NASH feel fine and don't know that they have it.

As NASH progresses and liver damage gets worse, you may start to have symptoms such as:

  • Jaundice, yellowish skin and eye color
  • Fatigue (feeling tired all the time)
  • Unexplained weight loss
  • General weakness
  • Ache or tenderness in the upper right abdomen

Diagnosis

There is no single test used to diagnose NASH, rather blood tests, imaging and biopsy are used in combination to determine NASH. A number of blood tests are available and newer multi-factor blood tests, may be able to accurately determine NASH and avoid unnecessary biopsy.

If you are at risk of liver disease, ask your doctor if liver screening is right for you. LiverFAStTM is a non-invasive liver disease screen for early detection of fatty liver, non-alcoholic steatohepatitis (NASH) and fibrosis. It is a simple, less expensive test that offers greater confidence in determining a patient’s level of liver injury and stage of liver disease. For more information contact us via email, or by phone at 1-888-552-1603.

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Sources: National Institute of Diabetes and Digestive and Kidney Diseases Stanford Health Care and the NASH Education Program

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