Steatohepatitis: Fatty Liver Disease Plus Inflammation

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Steatohepatitis is a type of liver disease characterized by the combination of excessive accumulation of fat in the cells of the liver and inflammation of the liver. This disease is classified as nonalcoholic steatohepatitis or NASD and alcoholic steatohepatitis or ASD. According to Cecil‘s Textbook of Medicine, obesity increases the risk of developing NASD, although this disease has been reported in people of normal weight. Habitual alcohol consumption is attributed to causing ASD. Untreated steatohepatitis progresses to cirrhosis. With cirrhosis, the liver deteriorates and healthy cells are replaced with scar tissue.

People with NASD can be asymptomatic but common and vague complaints include malaise and weakness. Upon physical examination, hepatomegaly or an enlarged liver is detected in about 75 percent of people with steatohepatitis. People with ASD experience flu-like symptoms such as malaise, weakness, and loss of appetite. Symptoms of severe ASD are the sudden onset of a tender and enlarged liver accompanied by jaundice and fever. Sometimes, individuals with ASD require hospitalization because of associated complications such as alcohol withdrawal, gastrointestinal bleeding, infections, and pancreatitis.

Abnormalities in blood test results point to steatohepatitis. An ultrasound of the abdomen is the most commonly used imaging study to diagnosis steatohepatitis. A MRI of the abdomen is a reliable noninvasive test for detecting steatohepatitis but it is expensive. A liver biopsy is performed to confirm a diagnosis of steatohepatitis.

Weight loss if overweight, increased physical activity, adapting a healthy diet, and abstinence from alcohol are recommended treatments for steatohepatitis. Referring to Cecil’s Textbook of Medicine, up to 50 percent of patients with severe ASD develop cirrhosis within five years. Cirrhosis can develop in people with either NASD or ASD in which scarring of the liver evolves gradually over one to two decades. Approximately 13 percent of all cases of hepatocellular carcinoma in the United States are associated with NASD.

Sources: Cecil’s Textbook of Medicine, Neurology and General Medicine
www.merckmedicus.com

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