If you think only alcoholics are susceptible to liver damage, you might be surprised to learn that you are wrong. Liver diseases happen to anyone, including those who abstain from alcohol. One of them is nonalcoholic steatohepatitis, also known as NASH. NASH is widely referred to as a silent disease and is hardly noticed until it gets to the severe stages. If it’s silent, can you spot it at all? Can you even treat it? Find detailed answers to these questions and more in this article.
What Is NASH?
What is NASH? NASH (nonalcoholic steatohepatitis) is a severe stage of nonalcoholic fatty liver disease, also known as NAFLD. It happens when the liver absorbs more fat than it can handle, leading to inflammation (hepatitis), scarring (cirrhosis), and damage to the liver tissues– even cancer. Nonalcoholic steatohepatitis progressively worsens if there are no actions to stop or control it.
NASH is often associated with metabolic disorders like type 2 diabetes, high triglycerides, and obesity. Also, it is usually diagnosed in adults 50 years and above, especially those with a record in their family. While the disease remains underdiagnosed and its causes not fully uncovered, studies show that it affects up to 5% of the world’s population.
Who Is at Risk of Developing NASH?
We stated earlier that NASH happens due to metabolic disorders and other reasons. This implies that people with these NASH-associated conditions or circumstances are at risk. They are explained below:
1. People With Metabolic Disorders
Metabolic disorders that pose risk factors for NASH include:
- Obesity: Obesity is being overweight, mainly due to fat. This excess fat in the body causes the liver to store more than it can handle. As a result, it gets inflamed and damaged
- Insulin Resistance: Insulin resistance is when the body cells are no longer responsive to insulin. This condition can lead to the development of NASH
- Dyslipidemia: Dyslipidemia is when the body has an unsafe or unusual amount of fats (also known as lipids) in the blood. People with dyslipidemia are at risk of developing NASH
- Type 2 Diabetes: This illness is a condition where the body cannot regulate blood sugar properly. This builds up fat in the liver, creating room for NASH to develop
- Metabolic Syndrome: Metabolic syndrome is a combination of metabolic disorders, including obesity, dyslipidemia, type 2 diabetes, and high blood pressure
2. People With NASH-causing Genetic Variants
Some people’s genes are designed to store large amounts of fat in the liver and to break down fats effectively. Research has also shown that some people’s genes are designed to be susceptible to high inflammation and oxidative stress on the liver. Also, people with the disease’s history in their family may develop it.
3. People With a Sedentary Lifestyle
Regular exercise is vital for the body. When an individual does not exercise their muscles, they do not use enough glucose and fatty acids from their body. This causes them to excessively build-up up these compounds in the body and means a greater risk of NASH.
Aside from glucose and fatty acid build-up, a lack of regular exercise causes the body to accumulate insulin in the blood and become less sensitive to it. It also subjects the body to oxidative stress, a NASH risk factor.
4. People with High-Calorie Diet
High-calorie diets cause the body to receive excess calories, which are further stored as fat in the organs, including the liver. Aside from excessive fat build-up, high-calorie consumption can reduce the body’s sensitivity to insulin. It can also cause the liver to be highly inflamed and increase its oxidative stress.
5. People Who Are Over 50
Research shows that NASH is common in individuals over 50. This is because, from this age, they have a slower metabolism rate, are susceptible to weight gain, and have the probability of becoming resistant to insulin. Also, they tend to develop health conditions and complications that further reduce their ability to fight liver inflammation and oxidative stress.
What Are the Symptoms of NASH Disease?
It is vital to note that the symptoms of NASH disease hardly become noticeable until its late stages. This is why it is called a “silent disease.” Here are the symptoms that are associated with NASH:
- Body weakness and fatigue
- Confusion and unclear speech
- Weight loss
- Spider-like blood vessels on the skin surface
- Swollen legs
- Abdominal pain, swelling, and discomfort
- Unusual itching
- Easy bruising
How to Diagnose NASH
Medical professionals can diagnose NASH through a series of medical tests and examinations. See the popular NASH diagnostic methods below:
1. Physical Examination
Physical examination entails the medical expert checking for any signs of liver damage. A sign can be a tender or enlarged liver.
2. Imaging Test
An imaging test is used to check for fibrosis or fatty liver indications. It is usually performed with a CT scan, ultrasound, or magnetic resonance imaging.
3. Blood Test
A blood test can be practical for checking if the body has Transaminitis, a state of having more liver enzymes than usual. Someone with an excessive amount of liver enzymes has traces of liver inflammation. Blood tests also help to check for low albumin and high bilirubin. Moreso, they are liver disease indicators.
4. Liver Biopsy
This method is more precise and accurate compared to others. It involves taking a part of the liver tissue and examining it under controlled conditions for any signs of damage or inflammation.
Treatment Methods For NASH
There are different effective methods for treating NASH. They are explained below.
1. Liver Transplant
A liver transplant often suffices as a final solution in cases where the liver is damaged beyond recovery.
1. Prescribed Medications
Although no specific medications fit NASH conditions, a few are usually adequate.
- a) Obeticholic Acid (OCA): OCA is an effective treatment for improving the liver’s functionality and reducing fibrosis.
- b) Vitamin E: Vitamin E is an antioxidant that lessens liver inflammation and helps the liver perform better.
- c) Metformin: Metformin is effective for type 2 diabetes. It also reduces excess fat in the liver to a significant percentage and reduces insulin resistance.
- d) Pioglitazone: Pioglitazone is also an effective treatment for type 2 diabetes, excess liver fat, and insulin resistance.
2. Bariatric Surgery
Bariatric surgery is a viable treatment method for obesity and NASH, especially in their severe states. The two most common types of Bariatric surgery are sleeve gastrectomy and gastric bypass surgery. They are proven medical procedures for weight loss and treating NASH.
3. Lifestyle Adjustment
Lifestyle adjustment is the basic procedure for treating NASH. It involves the patient adjusting their lifestyle to meet nutritional standards. They can exercise regularly, work out, and change their diet to adjust and stay healthy. They can also treat underlying illnesses to lessen the effects of NASH.
It is important to note that while these treatments could help a great deal, they may not apply to everyone. This is why it is essential to consult a medical professional for guidance.
Seek Medical Attention Today!
NASH is a silent liver disease, such that its symptoms are hardly visible until it becomes severe. It happens to people who rarely or never drink alcohol and occurs due to several factors, ranging from self-inflicted ones to those such as age and genetic makeup. If you experience any of these symptoms listed above, or any unusual signs, you should not hesitate to contact a medical professional.