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Nonalcoholic Steatohepatitis (NASH)

The inflammatory and progressive subtype of fatty liver disease unrelated to alcohol.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is Nonalcoholic Steatohepatitis (NASH)?

Nonalcoholic steatohepatitis (NASH) is characterized by hepatic fat accumulation in the absence of significant alcohol intake, together with hepatocyte injury (ballooning), lobular inflammation, and variable degrees of fibrosis. It is the progressive form within the nonalcoholic fatty liver disease (NAFLD) spectrum.

NASH is closely associated with metabolic syndrome, obesity, type 2 diabetes, and dyslipidemia. In recent years the term metabolic dysfunction-associated steatohepatitis (MASH) has also been used.

Diagnosis is typically made with imaging, biochemistry, and liver elastography; liver biopsy may be needed for definitive diagnosis. Without treatment, some patients progress to cirrhosis and hepatocellular carcinoma.

Symptoms

May be asymptomatic for a long time
Right upper quadrant fullness or mild pain
Chronic fatigue and weakness
Mild-to-moderate elevation of liver enzymes
Jaundice and ascites in advanced cases
Itching (late stages)
Poor appetite despite weight gain

Risk Factors

Obesity (especially central obesity)
Type 2 diabetes and insulin resistance
Components of metabolic syndrome
High triglycerides and low HDL cholesterol
Hypertension
Polycystic ovary syndrome
Hypothyroidism and sleep apnea

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When liver enzymes (ALT/AST) are elevated on blood tests
  • When ultrasound detects fatty liver
  • When fatigue accompanies features of metabolic syndrome
  • In those with a family history of liver disease
  • If rapid weight loss or jaundice develops

Treatment Methods

01
Gradual weight loss (7-10% reduction yields histological improvement)
02
Mediterranean-style diet and fructose avoidance
03
Regular aerobic exercise (at least 150 min/week)
04
Treatment of diabetes and dyslipidemia (pioglitazone, GLP-1 agonists)
05
Vitamin E supplementation (in selected non-diabetic cases)
06
Newly approved medications (resmetirom, etc.) and transplantation evaluation in advanced fibrosis

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.