by Kimberly Allen, RN
NASH or non-alcoholic steatohepatitis is an inflammation of the liver that is caused by a build up of fat deposits. NASH affects approximately 5% of Americans, however, as many as 20% of Americans have a “fatty liver” but has not developed the inflammation or damage to the lever yet. Although NASH can affect anyone over 10 years of age it is most commonly found in people between 40 to 60 years of age, it is also more common in women than men.
There are numerous factors that can lead to the development of NASH including obesity and diabetes. Over 70% of those diagnosed with NASH are obese while approximately 75% have type 2 diabetes. Hyperlipidemia is another condition that can lead to NASH with as many as 80% of those people diagnosed with NASH also have hyperlipidemia. There are also certain types of abdominal surgery, like gastric bypass surgery or surgery involving the removal of large sections of the small intestine or surgical by pass of areas of the small intestine, that have been linked to the development of NASH, Certain medications used to treat some medical conditions as well as certain pesticides have also been associated with the development of NASH. There are also certain medical conditions like Wilson’s disease or Weber-Christian disease that can lead to the development of NASH. However, NASH can also develop in people that don’t have any known risk factors.
NASH is frequently referred to as a “silent” liver disease because in the early stages of NASH there are usually no symptoms. In fact, most people that have NASH don’t realize they have it. However, as the disease progresses causing more damage to the liver you may experience symptoms like constant fatigue and generalized weakness as well as weight loss that occurs without dieting or any other clear reason. Some people also develop mild pain in their upper right abdomen that most describe as an ache. As NASH continues to worsen it can lead to scarring also known as fibrosis. As the scarring worsens it can lead to cirrhosis. Once NASH has progressed to develop cirrhosis the liver is no longer able to function properly and can cause symptoms including fluid retention, bleeding in the intestines and muscle wasting as well as liver failure.
Despite the increasing incidence of NASH there currently exists no standard treatment for the disease. All current therapies focus on reducing the risk factors including loosing weight if you are over weight or obese. Weight loss can not only improve your liver function tests but can to some extent reverse the condition. It is also important to maintain control of your blood sugar and cholesterol levels as well as your blood pressure with in normal limits. If you are taking medications that lead to the development of NASH talk with your doctor about changing to a different medication.
The best way to prevent NASH is to eat a healthy diet rich in fresh fruits and vegetables as well as whole grains. It’s also important to limit animal protein and eat healthy fats. Eating organic, pasture raised beef and poultry in small portions is significantly healthier than GMO and conventionally raised meat products. Exercise regularly and maintain a healthy weight. also if you work with pesticides or other chemicals read the instructions carefully and follow all safety precautions.
There is ongoing research in progress using antioxidants like betaine and selenium as well as vitamin E to treat NASH. There is also clinical trials using certain newer anti diabetic medications like metformin that are being sponsored by the National Institutes of Health along with other organizations throughout the US. If you are interested in learning more or participating in a study ask your Dr about a clinical center near you.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.