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Nonalcoholic steatohepatitis – causes, side effects and treatments at

Wednesday, May 30, 2018 by

Nonalcoholic fatty liver disease (NAFLD) refers to a condition wherein there is too much fat in the liver (steatosis). Nonalcoholic steatohepatitis (NASH) occurs when fat continues to build up and the liver becomes inflamed.

NAFLD typically causes no symptoms, but some have fatigue or malaise, or may feel discomfort or pain in the abdomen. Enlargement of liver (hepatomegaly) develops in about 75 percent of patients with NASH. Enlargement of the spleen (splenomegaly) may also develop. It can also sometimes cause liver cirrhosis (scarring).

NASH is commonly related to obesity, high blood pressure, diabetes, dyslipidemia, and/or metabolic syndrome, but not alcohol abuse. It most especially occurs in overweight women with Type 2 diabetes (glucose intolerance).

NASH is diagnosed most often in patients between 40 and 60 years old. Children and adolescents may be affected by pediatric NASH.

Known symptoms, risk factors for nonalcoholic steatohepatitis

The symptoms can resemble those of other conditions. Certain tests may determine if the following symptoms are caused by other conditions or NASH:

  • Abdominal swelling and discomfort/pain
  • Bleeding and bruising easily
  • Confusion, difficulty focusing
  • Itchy skin
  • Jaundice
  • Lack of energy
  • Muscle weakness
  • Nausea, vomiting, and diarrhea
  • Poor appetite
  • Tarry stools
  • Tiredness and fatigue
  • Weight loss

Body systems harmed by nonalcoholic steatohepatitis

Ten to 25 percent of people with NASH will eventually develop cirrhosis and liver failure. Hepatocellular carcinoma (a type of liver cancer) can also occur if the condition progresses and is left untreated.

Food items or nutrients that may prevent nonalcoholic steatohepatitis

A combination of a healthy diet, limited portion sizes, and maintaining a healthy weight can help prevent NAFLD, NASH and other conditions.

Your healthcare provider may suggest limiting your intake of fats to help prevent or treat NAFLD or NASH, especially if you are overweight or obese.

Replace saturated fats (meat, poultry skin, butter, lard, milk and dairy products) and trans fats (crackers, commercial snacks, commercially baked goods, and fried foods) in your diet with the following to reduce your chance of heart disease if you have NAFLD:

  • Monounsaturated fats (olive, peanut, and canola oils)
  • Polyunsaturated fats (corn, soybean, nuts), especially omega-3 fatty acids (oily fish, walnuts, flaxseed oil)

Your healthcare provider may suggest other dietary changes to help treat NAFLD and NASH and support liver health:

  • Add more low-glycemic index foods such as fruits, vegetables, and whole grains to help manage your blood glucose.
  • Avoid foods and drinks that contain large amounts of simple sugars, especially fructose, which is found in sweetened soft drinks, sports drinks, sweetened tea, and juices.
  • Avoid heavy alcohol consumption, which is injurious to your liver. Experts define heavy alcohol as more than four drinks per day for men and more than three drinks per day for women.

Treatments, management plans for nonalcoholic steatohepatitis

NASH may be treated through a combination of weight loss programs and medications to manage diabetes and hypertriglyceridemia. Lifestyle changes are made to control weight.

A typical treatment plan for an individual with NASH may include:

  • Controlling obesity through diet, exercise, and medication.
  • Controlling diabetes, hypercholesterolemia, and hypertriglyceridemia using medications and lifestyle changes.
  • Commonly used medications include thiazolidinediones, vitamin E, pentoxifylline, ursodeoxycholic acid, and others
  • Liver transplant may be required if NASH progresses to liver cirrhosis

Regardless of treatment, follow-up care and regular screening are important to ensure that NASH does not progress and cause further complications.

Where to learn more


Nonalcoholic steatohepatitis (NASH) refers to the inflammation of the liver due to accumulation of excess fat in the liver, that’s caused by factors other than alcohol consumption.

NASH may progress to liver cirrhosis (scarring) and even liver cancer if left untreated.

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