Liver: what is non-alcoholic steatohepatitis

By Cristiano Antonino On May 11, 2022

Cirrhosis is a degeneration of the liver, commonly associated with alcohol abuse or viral hepatitis. However, excessive alcohol consumption – harmful as it is – is not the only cause of cirrhosis

NASH – or non-alcoholic steatohepatitis – is a liver disease characterised by the accumulation of fat, the most fearsome complication of which is cirrhosis.

Not depending on alcohol intake, therefore, NASH can also affect abstemious people.

What is cirrhosis?

When we speak of cirrhosis we are referring to a liver degeneration linked to the excessive accumulation of fibrous tissue, which leads to alterations in its structure and function.

These factors can lead to increased pressure at the level of the liver’s main vein (the portal vein) and also to the organ’s inability to synthesise essential proteins for the body such as albumin.

This then leads to haemorrhages in the upper digestive tract, the appearance of ascites – fluid accumulating in the abdomen – and swelling in the legs.

In addition, the liver is unable to metabolise substances absorbed from the intestines and eliminate toxins.

Causes of cirrhosis, besides alcohol abuse and non-alcoholic steatohepatitis, in adults include:

hepatitis B;
hepatitis C;
autoimmune liver diseases caused by an overactive immune system;
iron or copper accumulation.

Non-alcoholic steatohepatitis: what causes it

Non-alcoholic steatohepatitis (NASH) is a disease related to the accumulation of fat in the liver.

It is a more serious condition than simple steatosis, also known as ‘fatty liver’, because non-alcoholic steatohepatitis leads to inflammatory processes, scarring and tissue death, which can ultimately alter organ function.

Non-alcoholic steatohepatitis is most easily found in people who are obese, overweight or generally have little physical activity, and is often associated with the presence of diabetes or metabolic syndrome.

The main causes of non-alcoholic steatohepatitis are:

incorrect diet, too rich in fat
overweight or obese condition;
dyslipidaemia, i.e. the presence of high levels of triglycerides and cholesterol in the blood;
type 2 diabetes.

Non-alcoholic steatohepatitis: symptoms

The symptoms of non-alcoholic steatohepatitis only occur when the stage of cirrhosis is already advanced, are common to all causes of cirrhosis and include:

ascites;
anaemia;
swelling of the legs;
bleeding of the gastrointestinal tract;
fatigue;
jaundice.

Cirrhosis can also give rise to liver tumours.

Steatohepatitis: how is it treated?

Before talking about treatment, it is important to talk about prevention: steatohepatitis can be combated in advance by avoiding a sedentary lifestyle, taking regular physical activity and following a balanced diet, rich in vegetable proteins, whole grains, fish and white meat, but low in red meat and as free as possible of sweets and alcohol.

In this sense, the Mediterranean diet is particularly suitable for losing weight and thus reducing the amount of steatosis.

Once steatosis has taken hold, the degenerative process that will lead non-alcoholic steatosis into liver fibrosis cannot be stopped with commercial drugs.

Lifestyle, however, must necessarily be altered, by improving diet, stopping sedentariness and banning alcohol.

To date, there are no registered drugs for the treatment of non-alcoholic steatohepatitis; however, there are numerous clinical trials with molecules with different mechanisms of action, some of which seem to be promising.

Hepatitis In Children, Here Is What The Italian National Institute Of Health Says

Acute Hepatitis In Children, Maggiore (Bambino Gesù): ‘Jaundice A Wake-Up Call’

Nobel Prize For Medicine To Scientists Who Discovered Hepatitis C Virus

Hepatic Steatosis: What It Is And How To Prevent It

Acute Hepatitis And Kidney Injury Due To Energy Drink Consuption: Case Report

The Different Types Of Hepatitis: Prevention And Treatment

Acute Hepatitis And Kidney Injury Due To Energy Drink Consuption: Case Report

New York, Mount Sinai Researchers Publish Study On Liver Disease In World Trade Center Rescuers

Acute Hepatitis Cases In Children: Learning About Viral Hepatitis

Hepatic Steatosis: Causes And Treatment Of Fatty Liver

Hepatopathy: Non-Invasive Tests To Assess Liver Disease