What is nonalcoholic steatohepatitis (NASH)?
Nonalcoholic steatohepatitis (NASH) is fat buildup and inflammation in the liver in people who drink little or no alcohol. It's a less common but more serious type of nonalcoholic fatty liver disease (NAFLD). NASH may get worse and cause scarring of the liver, which can lead to cirrhosis and liver failure.
What are the symptoms of nonalcoholic fatty liver disease (NAFLD)?
Most people who have NAFLD have no symptoms. Even people who have the more serious type called NASH may not have symptoms for many years. When symptoms occur, they may include feeling very tired. Or you may have pain or discomfort in the upper right part of your belly.
How is nonalcoholic fatty liver disease (NAFLD) diagnosed?
Your doctor will ask about your past health and any symptoms and will do a physical exam. The doctor may also do tests. For example, you may have:
- Blood tests, such as liver function tests.
- Imaging tests, such as an abdominal ultrasound, a CT scan, or an MRI.
Testing can help the doctor rule out other possible causes of fat in the liver. These include heavy alcohol use, certain medicines, and other liver diseases.
A special type of ultrasound or MRI may be done to see if a liver biopsy is needed. In a liver biopsy, a sample of liver tissue is removed and sent to a lab. A liver biopsy can show if you have scarring or the more serious type of NAFLD called NASH.
How is nonalcoholic fatty liver disease (NAFLD) treated?
Treatment focuses on managing related conditions like diabetes and making lifestyle changes, including losing weight if needed, eating a healthy diet, and being more active. A doctor may prescribe medicines for related conditions or to help with weight loss. Weight-loss surgery may be an option for people who have obesity.
How can you care for yourself when you have nonalcoholic fatty liver disease (NAFLD)?
- Lose weight if you need to. Losing even 5% of your weight can make a difference to your health. A healthy eating plan and being more active can help you manage your weight. But if you need more help, talk to your doctor about other weight-loss options.
- Manage other health problems. These may include diabetes, high blood pressure, and high cholesterol. If your doctor prescribes medicines, take them exactly as prescribed.
- Eat healthy foods. This includes vegetables, fruits, nuts, beans, lean meat, fish, and whole grains. Limit things that are not so good for you, like saturated fat and sugar.
- Be more active. Try to get at least 30 minutes of exercise 5 or more days of the week. Walking is a good choice.
- Avoid alcohol. Alcohol can damage the liver and cause other health problems.
- Don't use tobacco. Quitting tobacco can help to reduce your risk of future health problems.
- Get immunized. Having NAFLD increases your risk for infections, so it's important to get all recommended vaccines.
Nonalcoholic fatty liver disease (NAFLD): When to call
Call 911 anytime you think you may need emergency care. For example, call if:
- You have trouble breathing.
- You vomit blood or what looks like coffee grounds.
Call your doctor now or seek immediate medical care if:
- You feel very sleepy or confused.
- You have new or worse belly pain.
- You have a fever.
- There is a new or increasing yellow tint to your skin or the whites of your eyes.
- You have any abnormal bleeding, such as:
- Nosebleeds.
- Vaginal bleeding that is different (heavier, more frequent, at a different time of the month) than what you are used to.
- Bloody or black stools, or rectal bleeding.
- Bloody or pink urine.
Watch closely for changes in your health, and be sure to contact your doctor if:
- Your belly is getting bigger.
- You are gaining weight.
- Your symptoms get worse.
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