NASH: The silent and often forgotten cause of liver problems

Nonalcoholic Steatohepatitis, or NASH, is a more severe form of Nonalcoholic Fatty Liver Disease (NAFLD). It results when fat builds up in the liver causing inflammation, and it’s a growing health problem that is already the second-leading cause of liver transplant in the U.S. By 2020, it’s expected to be first. Over 12% of Americans are affected by NASH making it the second most common cause of liver transplant.

While I don’t deal with NASH myself, my mother has it. As I’ve said before, we don’t talk, but I think it’s important that I’m educated about it and help raise awareness of it among others. I’m not going to ignore that there is a genetic link – those that carry a certain gene have a greater chance of getting NAFLD and NASH.

There isn’t really one specific cause for NASH, but if you have type 2 diabetes, prediabetes, obesity, high cholesterol or high blood pressure you may be at greater risk.

In some cases, NASH patients might have pain in the upper right side of their abdomen along with fatigue. Symptoms like an enlarged liver, insulin resistance, and cirrhosis may lead to further testing. However, NASH can go undetected for decades because symptoms are often minimal until the disease has advanced, so if you’re at risk it’s critical to have regular blood function tests during your annual physicals. Blood tests, ultrasounds, CT scans, MRIs, or biopsies are other common types of testing for liver disease.

To me, the scariest thing about NASH is that over time, it can cause serious complications like cirrhosis (severe liver scarring) and liver cancer.

With no FDA-approved medications yet available to treat NASH, options for managing the disease are limited to diet and lifestyle modifications. If you or a loved one has NASH, talk to your doctor about participating in a clinical trial – you can learn more at www.NASHStudy.com. But for now, maintaining a healthier lifestyle is the best way to help control NASH and reduce some of the top risk factors like obesity.

Look, losing weight and eating healthy aren’t easy. Trust me, I know. It doesn’t get any easier the less active we are, though.

In the past, I have tended to overdo things when I’m feeling well from my various invisible illnesses. A few weeks ago, I went from agonizing pain to relief overnight and decided I should go running.

This was not a good idea for me.

Still, that doesn’t mean that I’m not active. Since finally getting the release from my rheumatologist to be able to do yoga again, I’ve been keeping up with stretching every single day. I try to do a bit every few hours.

Right now, that’s all I can do – and that’s okay. I know I can build up to being more active, especially as the weather outside becomes less full of ice and snow.

As far as eating goes, I just had a visit with my rheumatologist. Since I’m not able to be maybe as active as I’d like, we discussed supplementing some of my activity with a bit of a better diet. We talked about the potential benefits of a Mediterranean diet for those of us with autoimmune/autoinflammatory diseases and decided to head in that direction.

It makes the most sense for me anyway. When I cook, whatever meal it is tends to have an Italian spin on it.

My rheumatologist’s nurse always comes in last and we went over her tips and tricks for eating well – high-quality olive oil to dip bread in or fry up lean meats, a handful of nuts like almonds every day or so, and getting those fish-supplied Omega-3s.

The trip to the grocery store afterward wasn’t necessarily the cheapest, but the subtle changes I’ve made so far have, at the very least, helped me feel a little healthier. The nice thing is that we are giving it time. I have until my next appointment with them in July to fully adopt this diet.

Thank goodness, because I don’t know how I’m going to give up tacos… maybe I’ll just make them Italian.