Habiba Tunau MD

Did you know June 12th is International NASH Day? To be honest neither did I up until a few days ago. Apparently there is an organization set up to promote International NASH day to educate those of us who didn’t know of its existence and significance.  If you are non medical you may not know that NASH stands for Non-alcholic steatohepatitis.

What is this you might be wondering?  Basically, it is a condition that happens after the progression of “fatty liver”.  If you are overweight or obese and happened to have had some imaging, your doctor may have told you at one point or another that “you have an enlarged liver and it is more than likely just a fatty liver, no big deal, don’t worry too much”. Well “fatty liver” in itself may not be a big deal, but if left untreated may lead to a troublesome condition called NASH- which can progress to serious medical conditions such as liver cirrhosis, liver cancer, and heart disease which clearly none of us want!

What do you think of when you hear “Hepatitis”? Inflammation of the liver which many people can get from alcoholism or some sort of chronic viral hepatitis like hepatitis B or C ; However in this case, the cause of hepatitis associated with NASH is related to diets high in fat and sugar, obesity and diabetes among others. Certain hormone related conditions can also contribute to NASH like hypothyroidism, polycystic ovary syndrome or cushing’s syndrome. Certain drugs can also contribute to NASH like corticosteroids.

How do you know you have NASH? Let’s assume you are overweight or obese and consume a significant amount of fast food or fried foods. Or maybe your weakness is sugar and you like desserts or soft drinks/ sodas. You might even snore quite a bit and have obstructive sleep apnea. Your belly might be a little larger/fatter than it should be, but overall you think you feel fine and not complaining of anything major (although I will say obstructive sleep apnea is significant and should be treated) . As we say in medicine you could be “asymptomatic”  in other words no major symptom.

It is also possible that you may only have minimal or very mild discomfort on your upper right side of your abdomen.

You may see your primary care physician who may order lab tests and find that your liver enzymes are elevated.  Your provider may then choose to do some noninvasive imaging like an abdominal ultrasound or MRI . Eventually if the suspicion is high you may need to see a specialist and have an invasive liver biopsy for a definite diagnosis.

I am overweight or obese how can I prevent NASH ?

If you are overweight or obese, you have a significant risk of fatty liver, especially if you drink alcohol in excess.  Before you can get NASH you would have to have a fatty liver. However, fatty liver is reversible! Do what you can to reverse fatty liver by cutting back on alcohol, cutting back on fried foods, fast foods, and processed foods. Have your underlying medical problems that may contribute to NASH treated. Increase your activity level and  exercise while trying to shrink or reduce your waistline. Reducing your abdominal fat is very important and so is making healthy lifestyle changes BEFORE your fatty liver progresses to NASH. As you can see, prevention is better than a cure, especially in this case because if your fatty liver progresses to NASH and it is not treated, you could develop fibrosis and cirrhosis of the liver over the years and the treatment options are very limited.

Please spread the word and share this post!

Thank you

Habiba Tunau MD

( I am an Internist and not a liver specialist, the opinions above are mine and should not be taken as medical advice or treatment. Please see your provider )

For more on this subject please see: https://www.international-nash-day.com/