By Deborah Ng

When excess fat builds up in the liver, but is unrelated to alcohol consumption, it’s known as Non-Alcoholic Fatty Liver Disease (NAFLD). Non-Alcoholic Steatohepatitis (NASH) is a more serious form of NAFLD where this fat buildup leads to inflammation and can cause other damage to the liver.¹ If left untreated, NASH can lead to life-threatening conditions such as cirrhosis or liver cancer.[1] With this in mind, it’s important to learn more about NASH.

NASH risk factors

Certain health conditions may influence if a person is at risk for having NASH. Those who are obese have a higher likelihood of having NASH than someone who is at a healthy weight. Also at risk are people with Type 2 diabetes or insulin-resistance. High cholesterol and high triglyceride levels are also a factor, as is the presence of metabolic syndrome. However, not everyone who has NASH is obese or insulin-resistant, and you can have NASH even without these risk factors involved.[2]

NASH could be hereditary

Some people who develop NASH may be genetically predisposed to the condition.[1] If you have NASH in your family history, you could be at risk. Moreover, if members of your past and present family have suffered from Type 2 diabetes or obesity, you may be at risk.[3]

NASH can strike at any age

Because of the rising obesity rate in children, kids are also being diagnosed with NASH.[4] In fact, NASH is the most common liver ailment for children between the ages of 2 and 19, with males more likely to have NASH than females.[4] In addition to obesity, insulin resistance is also believed to play a factor in pediatric NASH.

You may not know you have NASH... at first

NASH is often called a “silent” disease because many people experience few or no symptoms until the disease is at an advanced stage.[1] In most cases, it’s not until the doctor tests for other conditions or as part of a routine check-up that NASH is suspected. Though there are no symptoms that are exclusive to NASH, those who suffer from the disease may feel tired and experience bloating as well as discomfort on the upper right side of their abdomen. Anyone who has persistent symptoms is encouraged to see their doctor.

NASH may be reversible

If you've been diagnosed with NASH, there's good news on the horizon. You may be able to reverse the effects of early stage NASH with healthy lifestyle changes. Eating properly and getting regular exercise can help you to lose weight and lower your cholesterol, and help to eliminate the factors that led to NASH in the first place. In fact, you may even see benefits in the liver after just a 7-10% weight loss.

However, patients who are at an advanced stage of NASH, where there is serious liver damage, may not be able to reverse their disease by changing their lifestyle.

Currently, there is no FDA or EMA approved therapy to control or eliminate NASH and its symptoms, however, research to uncover potential new treatments is ongoing.

[1] National Institute of Diabetes and Digestive and Kidney Diseases, Definition and Facts of NAFLD and NASH. Updated November 2016. Accessed November 3, 2017.

[2] Margariti E, Deutsch M, Manolakopoulos S, et al. Nonalcoholic fatty liver disease may develop in individuals with normal body mass index. Ann Gastroenterol. 2012

[3] Loomba, R., et al. Association between diabetes, family history of diabetes, and risk of nonalcoholic steatohepatitis and fibrosis. Hepatology. 2012;56:943-951

[4] Nierengarten, MA Mary Beth. “Pediatric Nonalcoholic Fatty Liver Disease.” Contemporary Pediatrics, 1 Sept. 2013, http://contemporarypediatrics.modernmedicine.com/contemporary-pediatrics/content/tags/biomarker/pediatric-nonalcoholic-fatty-liver-disease