Summary about Disease
Steatohepatitis is a type of nonalcoholic fatty liver disease (NAFLD) characterized by inflammation of the liver, along with fat accumulation. It can progress to cirrhosis, liver failure, and liver cancer. There are two main types: Nonalcoholic steatohepatitis (NASH) which occurs in people who drink little to no alcohol, and Alcoholic steatohepatitis, which is caused by heavy alcohol use. NASH is frequently associated with obesity, diabetes, high cholesterol, and high blood pressure.
Symptoms
Many people with steatohepatitis have no symptoms, especially in the early stages. When symptoms do occur, they may include:
Fatigue
Abdominal pain or discomfort (usually in the upper right side)
Weakness
Enlarged liver
Yellowing of the skin and eyes (jaundice) - indicates advanced liver damage
Swelling in the legs and abdomen (edema and ascites) - indicates advanced liver damage
Causes
Nonalcoholic Steatohepatitis (NASH): The exact cause is not fully understood, but it is strongly linked to:
Obesity
Insulin resistance (often associated with type 2 diabetes)
High cholesterol and triglycerides
High blood pressure
Metabolic syndrome
Alcoholic Steatohepatitis: Caused by long-term, excessive alcohol consumption. The amount of alcohol needed to cause the disease varies.
Medicine Used
There are no FDA-approved medications specifically for NASH. Treatment focuses on managing the underlying conditions and risk factors, and preventing further liver damage. The following may be used:
Medications for diabetes: To improve insulin sensitivity.
Medications for high cholesterol: Statins, fibrates, etc., to lower cholesterol levels.
Weight-loss medications: Under medical supervision.
Vitamin E: An antioxidant; sometimes used, but effectiveness is still under investigation and can have side effects.
Investigational Drugs: Clinical trials are ongoing to evaluate potential new drug therapies for NASH.
Alcoholic steatohepatitis: Abstinence from alcohol is crucial. Medications to reduce alcohol cravings may be used.
Is Communicable
No, steatohepatitis is not communicable. It is not an infectious disease and cannot be spread from person to person.
Precautions
Maintain a healthy weight: Weight loss through diet and exercise can significantly improve liver health.
Control diabetes: Manage blood sugar levels through diet, exercise, and medication.
Lower cholesterol and triglycerides: Follow a healthy diet and take medication as prescribed.
Limit or avoid alcohol: Crucial for both NASH and alcoholic steatohepatitis.
Eat a healthy diet: Focus on fruits, vegetables, whole grains, and lean protein. Avoid processed foods, sugary drinks, and excessive saturated and trans fats.
Exercise regularly: Aim for at least 30 minutes of moderate-intensity exercise most days of the week.
Get vaccinated: Against hepatitis A and B (if not already immune).
Consult with your doctor: Regularly monitor your liver health, especially if you have risk factors for steatohepatitis.
How long does an outbreak last?
Steatohepatitis is not an "outbreak" in the traditional sense of an infectious disease. It's a chronic condition. The progression of the disease varies greatly from person to person. In some individuals, the disease progresses slowly over many years, while in others, it can progress more rapidly. Progression depends on factors like the underlying cause (NASH vs. alcoholic), the presence of other medical conditions, and lifestyle choices.
How is it diagnosed?
Blood tests: Liver function tests (ALT, AST, bilirubin, alkaline phosphatase) can indicate liver damage.
Imaging tests:
Ultrasound: Can detect fatty liver.
CT scan or MRI: More detailed images of the liver.
Liver biopsy: The most accurate way to diagnose steatohepatitis and assess the severity of inflammation and scarring. A small sample of liver tissue is removed and examined under a microscope.
Timeline of Symptoms
The timeline of symptoms is highly variable.
Early stages: Often asymptomatic.
Progression to NASH or alcoholic steatohepatitis: Fatigue and mild abdominal discomfort may develop.
Advanced stages (cirrhosis): Jaundice, edema, ascites, internal bleeding, and confusion (hepatic encephalopathy) can occur. The time it takes to progress through these stages can range from years to decades.
Important Considerations
Early diagnosis and intervention are crucial to prevent the progression of steatohepatitis to cirrhosis and liver failure.
Lifestyle modifications (diet, exercise, weight loss) are the cornerstone of treatment for NASH.
Abstinence from alcohol is essential for alcoholic steatohepatitis.
Regular monitoring by a healthcare professional is important to track liver health and adjust treatment as needed.
People with steatohepatitis are at increased risk for other health problems, such as cardiovascular disease and certain types of cancer.
Liver transplantation may be an option for individuals with advanced liver disease (cirrhosis or liver failure).