What is NASH?

Non-alcoholic steatohepatitis (NASH) 

Non-alcoholic steatohepatitis (NASH) is a stage of liver disease after NAFLD. It is due excess fat deposits in the liver and the inflammation that ensues due to it. Unlike NAFLD, there is extensive damage to the liver parenchyma. All the conditions which cause NAFLD, also lead to NASH which include: -

1)    Uncontrolled/ poorly controlled Diabetes Mellitus

2)    Unbalanced diet high in fat content

3)    High serum cholesterol due to any cause

4)    High serum triglycerides due to any cause

5)    Metabolic syndrome

6)    Polycystic ovarian syndrome

7)    Hypothyroidism

Signs and symptoms

1)    Right upper quadrant pain

2)    Nausea

3)    Yellowness of the eyes and mucosal membranes (jaundice)

4)    Fatigue and generalized weakness

5)    Decreased appetite

6)    Easy bruising and bleeding

7)    Abdominal distension due to fluid collection

 

Management

Clinical signs and symptoms along with tests which indicate liver damage aid in diagnosis of NASH. The tests include: -

a)    Blood tests-

i)                Liver function tests- AST, ALT, ALP, serum albumin and prothrombin time

ii)               Complete blood count may show low Hb and decreased platelet count

iii)             Blood glucose

iv)             Lipid profile

v)               Thyroid function tests

 

b)    Diagnostic techniques

i)                Fibro scan

ii)               Ultrasonography of abdomen

iii)             MR (magnetic resonance) elastography

iv)             Liver Biopsy

 

Complications

1)    Acute liver failure

2)    Cirrhosis of liver

3)    Aggravation of diabetes mellitus and metabolic disturbances

 

Treatment

1)    Control of diabetes mellitus

2)    Exercise and diet control to promote weight loss