Nonalcoholic fatty liver disease or nonalcoholic steatohepatitis (NASH) is a liver disease that occurs in people who do not drink alcohol. NASH causes high amounts of fat to accumulate in the liver and makes it appear swollen and inflamed. In severe cases nonalcoholic steatohepatitis leads to liver cirrhosis, or permanent scarring of the liver tissue, making it hard and unable to function properly. Obesity, diabetes and high cholesterol levels all contribute to this disease. NASH has several guidelines to be followed.
Diagnosis
A patient is suspected of having this disease if he is found to have elevated liver enzyme test results, specifically the ALT, or alanine aminotransferace, and AST, or aspartate aminotranferace. X-rays and ultrasound images can also show abnormal fat accumulation in the liver. The diagnostic procedure used to confirm NASH is liver biopsy. Liver tissue found positive for NASH shows fatty deposits, inflammation and damage to the liver's cells.
Symptoms
According to the Mayo Clinic, NASH is an asymptomatic liver disease, especially during its early stages. Symptoms begin to appear once the disease becomes more advanced or when liver cirrhosis develops. Symptoms for nonalcoholic steatohepatitis include fatigue, weight loss and body weakness. When this disease worsens, the liver becomes heavily scarred and hard. In severe stages, liver cirrhosis can lead to liver failure and when this happens, the patient can manifest symptoms such as fluid retention, muscle wasting and intestinal bleeding.
Causes
As mentioned in the National Digestive Diseases Information Clearinghouse, nonalcoholic steatohepatitis is most common in middle-aged and obese individuals. Non-obese individuals who have elevated blood cholesterol and triglyceride levels are also at risk for developing NASH. Other underlying conditions, such as insulin resistance, release of cytokines -- a toxic and inflammatory protein -- as well as deterioration of liver cells can also contribute to nonalcoholic steatohepatitis.
Treatment
According to the Mayo Clinic, NASH does not have a standard treatment. Patients who are at risk are advised to lose weight and increase physical activity as well as follow a balanced and healthy diet. Avoiding alcoholic beverages and unnecessary prescription and over-the-counter medications also helps. Taking antioxidants like vitamin E, selenium and betaine can help reduce oxidative stress in the liver's cells. In case of liver failure, liver transplant is the recommended treatment option.
