Non-Alcoholic Steatohepatitis - NASH

What Is NASH?

NASH is a form of non-alcoholic fatty liver disease (NAFLD). It is where there is a build-up of fat in the liver. Inflammation and liver damage are also present. This can lead to scarring of the liver, cirrhosis, and liver cancer. The NIDDKD reports that only a small percentage of people with NAFLD have NASH. 30-40% of people in the US have NAFLD. However, only 3-12% have NASH.

What Causes NASH And What Are Its Symptoms?

NASH tends to be a silent disease with few to no symptoms. Some people may have pain in the upper right side of their abdomen. They may also feel unusually tired. However, most people do not know that they have the disease. This is even when it has progressed to cirrhosis.

NASH is usually related to other health conditions that are present. These include obesity, type 2 diabetes, high blood pressure and metabolic syndrome. It also includes abnormal blood levels of cholesterol and triglycerides. Genetics may also play a role in the development of NASH.

How Is NASH Diagnosed?

When you see your GI Doctor, the first thing he/she will do is get a complete medical history and physical exam. The history is useful to your doctor. Because it reveals health conditions that can cause NASH. It also shows the type of diet and lifestyle you follow. During the physical exam, your doctor looks for enlargement of the liver, jaundice, and insulin resistance. This can be seen as dark patches over the knuckles and elbows. Once the history and physical are completed, this gives your doctor an idea of the testing. That needs to be performed. This can include lab tests, imaging studies, and a liver biopsy. A new imaging study, Fibroscan, is now available at DHAT.

What Is the Fibroscan And How Is It Used to Diagnose NASH?

Fibroscan is the newest technology. It is to provide a non-invasive assessment of liver disease. Before this technology was available, liver biopsy was the gold standard in diagnosing NASH. Additionally, this test has many disadvantages including being invasive. Also requiring sedation with risks of pain and bleeding afterward. Now, Fibroscan can assess liver health painlessly and non-invasively in a five to ten-minute procedure.

How Is the Fibroscan Exam Performed?

Before having this test performed, you need to be fasting for at least three hours before. The exam is a simple procedure where you lie on the table. This will be with your right arm above your head. The healthcare provider puts a gel on your skin. It places the probe with slight pressure on the right side of your rib cage. The procedure takes measurements of sound waves passing through the liver. It then converts it into a measurement called liver stiffness. These measurements help your doctor determine if you have NASH.

Fibroscan At Digestive Health Associates of Texas (DHAT)

We are excited at DHAT to be able to offer our patients this non-invasive form of diagnosing and monitoring liver disease. When liver biopsy was relied upon for the diagnosis of liver disease, the results were not immediately available. Now, Fibroscan provides immediate results that are interpreted. This is by the doctor allowing for faster and more efficient treatment of NASH.

Advantages of Fibroscan include a quick and painless exam, larger area of examination and consistent results. It is covered by most insurance plans. If you are pregnant, a Fibroscan cannot be done. With this new technology in our practice, we will be able to screen for NASH more effectively. We will determine whether or not there is cirrhosis present. This will allow us to begin treatment earlier. It will be more effective medications to control the diseases.

The Fibroscan exam can be ordered by any of our DHAT physicians. It is performed at our DHAT Research Institute in Richardson, TX. If you are concerned about any symptoms that you are having or that you might have NASH. Call Digestive Health Associates of Texas today to schedule an appointment.