Nonalcoholic Steatohepatitis or NASH Syndrome

What Is Nonalcoholic Steatohepatitis Or NASH Syndrome?

Nonalcoholic Steatohepatitis or NASH Syndrome is quite a common liver disease. Its signs and symptoms may be similar to that of liver diseases caused due to excessive alcohol intake but this disease is found in people who consume little or no alcohol. The characteristic feature of Nonalcoholic Steatohepatitis or NASH Syndrome is the presence of fat in the liver along with significant damage to the liver. Majority of individuals with this disease do not have any symptoms and often feel well without realizing that they have this problem. Nevertheless, Nonalcoholic Steatohepatitis or NASH Syndrome can become severe resulting in cirrhosis of the liver in which case the liver starts to malfunction resulting in variety of potentially serious complications. In the United States, approximately 6-7% of the population is affected with Nonalcoholic Steatohepatitis or NASH Syndrome. Another 20% may have another condition of the liver in which fat is deposited in the liver called Fatty Liver Disease. This condition is becoming a common problem in the United States of late due to the amount of people suffering from obesity. In the last decade, the number of people with obesity has magnified due to unhealthy lifestyle and unhealthy dietary habits.

Nonalcoholic Steatohepatitis or NASH Syndrome

What Are The Causes Of Nonalcoholic Steatohepatitis Or Nash Syndrome?

Even though Nonalcoholic Steatohepatitis or NASH Syndrome is quite a common medical condition, its exact cause still remains unknown. This disease is generally found in people in their late 30s and who are overweight. It is also found that many individuals with this disease have elevated cholesterol and triglycerides and may even suffer from diabetes but this is not a parameter for developing Nonalcoholic Steatohepatitis or NASH Syndrome. Even individuals who are not obese or do not have diabetes can have this disease. This disease does not have a risk factor. In some cases it is even identified in children. Hence, it can be said that obesity is not a parameter for developing Nonalcoholic Steatohepatitis or NASH Syndrome. Even though the root cause of Nonalcoholic Steatohepatitis or NASH Syndrome is unknown, several factors are identified which may cause this disease and those factors are:

  • Insulin resistance
  • Release of toxic inflammatory proteins
  • Deterioration of cells inside liver

What Are The Symptoms Of Nonalcoholic Steatohepatitis Or NASH Syndrome?

Nonalcoholic Steatohepatitis or NASH Syndrome rarely causes any symptom. Majority of individuals with this disease do not even realize that they have a problem with their liver. Symptoms usually develop when the disease becomes more advanced and there is cirrhosis of the liver. These symptoms are severe fatigue, weight loss, and weakness. Nonalcoholic Steatohepatitis or NASH Syndrome progresses extremely slowly and it may take significant number of years before this disease reaches its advanced stage. In some cases, the progression of the disease has stopped on its own without any directed treatment. In some cases, Nonalcoholic Steatohepatitis or NASH Syndrome starts worsening causing scaring of the liver resulting in cirrhosis of the liver, thus making it extremely hard for the liver to function normally. It is not a thumb-rule that every individual with Nonalcoholic Steatohepatitis or NASH Syndrome will go on to develop cirrhosis of the liver but once cirrhosis develops then it becomes very difficult to treat the condition. Some of the symptoms of cirrhosis of liver are fluid retention, wasting of muscles, intestinal bleeding, and liver failure. If there is development of cirrhosis of liver in an individual, then liver transplantation is the only treatment for this condition. Nonalcoholic Steatohepatitis or NASH Syndrome is one of the major causes of cirrhosis in United States after hepatitis and alcoholic liver disease.

How Is Nonalcoholic Steatohepatitis Or NASH Syndrome Diagnosed?

Nonalcoholic Steatohepatitis or NASH Syndrome is suspected when there are elevations in the liver function tests on routine examinations without any apparent history of alcohol use or any other risk factors like medications or viral hepatitis. When an x-ray is done of the liver, it will show fatty deposits, which further confirms this disease. For a confirmatory diagnosis, a liver biopsy is conducted which will reveal fat along with inflammation and damage to liver cells. Important information from the biopsy also is whether there is development of scar tissue in the liver.

What Are Treatments For Nonalcoholic Steatohepatitis Or NASH Syndrome?

As of now, there is no definitive cure for Nonalcoholic Steatohepatitis or NASH Syndrome. The treating physician advises the following to the affected individual to slow down the progression of the disease process:

  • In case of an obese patient, weight reduction is imperative
  • Following a healthy diet
  • Being physically active
  • Total abstinence from alcohol
  • Avoiding frequent intake of medications which can be avoided

These are the major recommendations that a physician makes for an individual with Nonalcoholic Steatohepatitis or NASH Syndrome. The above recommendations are also helpful for other conditions like diabetes or hypercholesterolemia. Maintaining an ideal weight is extremely important as it improves the liver function and may even reverse the damage caused to the liver due to Nonalcoholic Steatohepatitis or NASH Syndrome. Individuals with Nonalcoholic Steatohepatitis or NASH Syndrome also have other medical conditions like diabetes, hypertension, or hypercholesterolemia and such conditions should be managed adequately and controlled.

Investigations are still underway to find a definitive treatment for Nonalcoholic Steatohepatitis or NASH Syndrome. Some of the experimental treatments include use of antioxidants like vitamin E or selenium. These medications reduce the oxidative stress that is increased in the liver in individuals with this disease. The efficacy of these medications is still to be proven.

Comprehensive Diet Plan For Nonalcoholic Steatohepatitis Or NASH Syndrome

The diet plan for Nonalcoholic Steatohepatitis or NASH Syndrome is as mentioned below:

  • Limiting Consumption of Fructose: It is highly recommended in studies that limiting consumption of fructose which is found in plenty in Fast Foods is quite helpful in Nonalcoholic Steatohepatitis as it slows down the progression of disease. Fructose is also found in sweetened beverages, fruit juices, and quite a few processed foods.
  • Limiting Cholesterol: It is recommended that individuals with Nonalcoholic Steatohepatitis should limit cholesterol in their diet. Foods that contain high level of cholesterol are dairy products, meat, eggs, fish etc. Cholesterol may increase inflammation of the liver in people Nonalcoholic Steatohepatitis.
  • Limit Consumption of Fat and Alcohol: It is imperative to limit foods which are high in fat content, as it facilitates inflammation of liver in Nonalcoholic Steatohepatitis and also makes an individual obese. Also, important is to completely abstain from alcohol as it puts extra pressure on the liver.
  • Other Dietary Consideration: Increasing antioxidants in diet is helpful for people with Nonalcoholic Steatohepatitis, although studies are still in progress as to its efficacy in controlling Nonalcoholic Steatohepatitis. Some of the antioxidants include vitamin E and selenium. Some of the foods that have high antioxidant properties are spinach, almonds, peanuts, sunflower seeds. Some foods rich in selenium are shrimp, Brazil nuts, turkey, beef, and eggs.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: March 13, 2015

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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