Steatohepatitis

Steatohepatitis is a type of fatty liver disease, characterized by inflammation of the liver with concurrent fat accumulation in liver. Morphologically it is similar to alcoholic liver disease but can occur in those who drink little to no alcohol. The disease is divided into alcoholic steatohepatitis (ASH) and nonalcoholic steatohepatitis (NASH). The disease process is thought to begin with the accumulation of fat in liver cells, which leads to liver inflammation and the development of fibrosis, or scarring, of the liver. If the process continues, it can lead to cirrhosis, liver failure, and liver cancer.

Causes

The exact cause of steatohepatitis is not known, but it is associated with several conditions including obesity, insulin resistance, and hyperlipidemia. In the case of alcoholic steatohepatitis, excessive alcohol consumption is the cause.

Symptoms

Steatohepatitis is usually asymptomatic and is often discovered incidentally due to abnormal liver function tests or hepatomegaly noted in unrelated medical conditions. For those who do have symptoms, they can include fatigue, weight loss, and abdominal discomfort.

Diagnosis

Diagnosis of steatohepatitis is made through a combination of history, blood tests, imaging, and sometimes a liver biopsy. Blood tests typically show elevated liver enzymes, and imaging can show fat in the liver. A liver biopsy can confirm the diagnosis and assess the degree of liver damage.

Treatment

Treatment of steatohepatitis involves addressing the underlying causes, such as reducing alcohol consumption in alcoholic steatohepatitis and improving metabolic risk factors in nonalcoholic steatohepatitis. This can include weight loss, treating insulin resistance, and treating hyperlipidemia.

Prognosis

The prognosis of steatohepatitis depends on the degree of liver damage, the presence of cirrhosis, and the individual's response to treatment. If left untreated, it can progress to cirrhosis and liver failure.

See also

• Fatty liver
• Alcoholic liver disease
• Non-alcoholic fatty liver disease
• Cirrhosis
• Liver failure
• Liver cancer

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