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Health & Support
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for anyone out there this is a fairly new disease. There are no symtoms but I was diagnosed because I was having gall bladder symtoms. this disease has to do with your liver not filtering properly and you develop a layer of fat on top of it. I went to the specialist today and the only way to cure it is lose weight slowly and folow a healthy diet and regular exerciseand drink lots of water. He also told me that if you do nothing about it you will devlop cancer of the liver.. Also he said not to look at my weight but keep my bmi index between 25-27. It is very important to follow a high fibre diet. O hope this information is helpfull
Edited May 10 2007 03:43 by united2gether
Reason: removed all caps in title
6 Replies (last)
i'm sorry {{{sleepy}}}

I had never heard of this, but found a good link with more information /nash/

sounds like your doctor gave you the current standard approach about maintaining a good weight and eating well.

it sounds like there is a little more research going on... (excerpt from the article)

Another experimental approach to treating NASH is the use of newer antidiabetic medications‚??even in persons without diabetes. Most patients with NASH have insulin resistance, meaning that the insulin normally present in the bloodstream is less effective for them in controlling blood glucose and fatty acids in the blood than it is for people who do not have NASH. The newer antidiabetic medications make the body more sensitive to insulin and may help reduce liver injury in patients with NASH. Studies of these medications‚??including metformin, rosiglitazone, and pioglitazone‚??are being sponsored by the National Institutes of Health and should answer the question of whether these medications are beneficial in NASH


thank you for the info I am going to check it out. there is still more research being done on this as it is fairly new.

p.s thanks for being a friend{{{united2gether}}}
just so people know what we're talking about, here are a few terms:

NAFLD = non-alcoholic fatty liver disease (a broader term that includes NASH as well as fatty changes in the liver without hepatitis.  "non-alcoholic" is in this term since excessive alcohol intake results in fat in the liver that looks similar on liver biopsy, and we typically exclude alcohol use by asking the patient).

NASH = non-alcoholic steatohepatitis (fatty liver disease in which there is active inflammation and scaring may or has begun to occur)

Although NASH is a relatively new term, it is not a new liver disease.  In the past we typically lumped these patients into the "cryptogenic" (e.g. unknown cause) which covered a number of different causes.

The majority of patients who are significantly obese have fatty change in the liver.  There are changes on imaging (i.e. CT, MRI, and abdominal ultrasound) that are very suggestive of NAFLD.  NASH is when you have active inflammation in the liver and occurs in a relatively small subset of people with fatty liver disease.  You can only diagnose NASH by liver biopsy or if you have imaging findings of cirrhosis (irregular small liver due to scarring in the liver).

The problem isn't fat on the liver, but inside the liver cells ("hepatocytes").  Exactly why fat builds up in these cells, how it causes damage, and why only some people with fatty liver develop NASH and cirrhosis is a very active area of research (and a bit too complex to discuss there).   However, obesity and insulin resistance (diabetes or "metabolic syndrome" - central obesity, hypertension, high cholesterol, blood glucose control impairment) are underlying causes.

Weight loss is the only thing that will definitely improve NAFLD.  Typically we recommend no losing more than 1 kg (2.2 pounds) per week since more rapid weight loss increases the risk of worsening of NAFLD and also of gallstones.  At this point, the evidence for drugs such as Metformin and Avandia are not strong enough that we routinely recommend them.

Although I typically discuss dietary changes with patients with a goal towards weight loss, there is no evidence that any particular change such as increasing fiber or water intake helps.  We believe decreasing dietary fat helps, and its a good idea for weight loss.

Liver cancer is a very rare complication of NASH (but does occur).  Liver cancer ("hepatocellular carcinoma") almost always occurs in the context of significant cirrhosis (i.e. advance liver disease).  I think may physicians mention it since it is something they hope will motivate change.  Much more likely outcomes of doing nothing about are: hypertension, developing diabetes, having a heart or stroke, arthritis in the knees and back, and possibly developing cirrhosis and liver failure in the future.  Not that these are much better.
Dr biff, that was a pretty good description and explanation, thanks. I have fatty liver and HCV and can't get treated for the HCV unless I lose at least 70 lbs. I have scarring and inflammation they found on biopsy, so I"m pretty motivated. It's a hard thing to deal with. I wish I knew of some foods made it worse, or being on a lower fat diet, etc, but I haven't found any advice like that. I just eat a good balanced diet of whole foods, as few processed foods as possible and keep the fats, carbs, and protiens balanced, but it's really slow losing. Stress and fatigue seem to slow it down even further.

you don't want to lose to fast my doctor told me with nash slow and steady is the way to go and drink lots of water and of course a high fibre diet and anything fried will make it worse stay away from greasy food. since finding out in jan i have lost 32 pounds and the doc says that is the right pace so i am sticking to what I am doing.
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I know I'm responding to a 2007 post regarding the liver disease NASH, but I'm still searching for any answers I can get or any new information.  My father was diagnosed last year october 08 with NASh... he had lack of appetite, weight gain the week before the hospital admitted him, turned extremely white (not jaundice at all), pain in lower side. 

Found out he had Cirrosis on his liver, never drank in his life and had a bioposy to determine he had NASH.  He was skinny his entire life until he hit his mid-40's and put on some weight, but he's 6 ft and currently 194 but at the time of admitted he was around 230.. that was due to the water retaining in his body.

As a family we are very confused why he has got this disease and are still searching for answers.  I'm a teacher and if it's food that brought him to this I have a million students daily who eat fast food and are well above their weight limit.  I would like to know if any current research is occuring this year as of 09 to help this disease?? If not.. than as a country we can defiinitely see this disease being one of the biggest "silent" killers in the near future. 

I can locate some old research, but nothing new.. the old data from the old reasearch is inconclusive and the study groups were extremely small.  I don't think were doing enough or educating the public on this disease to make them aware..

Note:  my father has no history of diabetes, not severly overweight (he's 67  6 ft. 194 was 230 two weeks before going to hospital), never been to the doctor before.  Never been sick.  He even lives in a remote area with 1 fast food chain and eats homemade dinners that my mom cooks daily.  Doesn't drink, works in the yard all the time.  He doesn't fit any of the categories of the disease, which makes all of this hard for me to absorb and understand. Never had any sugeries etc.

any "new" additional iinformation would be greatly appreciated. 





6 Replies