Thursday, October 21, 2010

Fatty Liver Disease (NASH) an Update

NASH (Non-alcoholic steatohepatitis)

Scientists in 1980 noted changes on liver biopsies in people that were non-alcoholics, the liver samples looked comparable to liver damage seen in chronic alcoholics who continue to drink.

They noted excess fat, and signs of dying liver cells (necrosis), and inflammation. They termed this condition non-alcoholic steatohepatitis, commonly referred to as NASH. (The phrase "steato" simply means fat and "hepatitis" means liver inflammation.)

Information On Fatty Liver :
From Merck
The fatty liver may or may not be inflamed. Inflammation may then develop into scarring (fibrosis). Fibrosis often progresses into cirrhosis. Fatty liver (with or without fibrosis) due to any condition except alcoholism is called nonalcoholic steatohepatitis. This disorder develops most often in people with the metabolic syndrome.
Symptoms and Diagnosis
Fatty liver usually causes no symptoms. Some people may feel tired or have vague abdominal discomfort. The liver tends to enlarge and can be detected by the doctor during a physical examination. If doctors suspect fatty liver, they'll ask about alcohol use. This information is crucial. Continued and excessive alcohol use will cause severe liver damage.
Blood tests to detect liver abnormalities, such as inflammation, are important , as this type of hepatitis may lead to cirrhosis. Additional blood tests help exclude other causes of liver abnormalities, such as viral hepatitis. Ultrasonography, computed tomography (CT), or magnetic resonance imaging (MRI) of the abdomen can detect excess fat in the liver but cannot determine if inflammation or fibrosis is present.
Liver biopsy may be necessary to confirm the diagnosis. For the biopsy, a doctor inserts a long hollow needle through the skin (anaesthetized locally to lessen any pain) and into the liver to obtain a small piece of liver tissue for examination under a microscope . The biopsy can help determine whether fatty liver is present, whether it resulted from alcohol or certain other specific causes, and how severe the liver damage is.
Prognosis and Treatment *also see below
Treatment focuses on minimizing or eliminating the cause of fatty liver. People should stop taking a drug, lose weight, or take measures to control diabetes, lower triglyceride levels, or stop drinking.
Excess fat in the liver alone is not necessarily a serious problem. For example, if alcoholism is the cause, the fat can disappear, usually within 6 weeks, when people stop drinking. If the cause is not identified and remedied, fatty liver can have serious consequences. For example, if excessive alcohol use continues or a drug causing fatty liver is not stopped, repeated liver injury may eventually lead to cirrhosis. Microvesicular steatosis has a worse prognosis. .
The progression In NASH:
The presence of dying liver cells and inflammation makes NASH a more severe form of fatty liver.
1. normal healthy liver
2. fatty liver (steatosis)
3. inflammation, cell death (steatohepatitis, NASH)
4. scar tissue (fibrosis)
5. excessive scar tissue and liver failure (cirrhosis)
Fatty Liver In The News : An Update
Just this month two studies presented at the 75th Annual Scientific Meeting of the American College of Gastroenterology investigated the effectiveness of potential treatments for NASH: Encouraging findings suggest new avenues for treating liver disease in overweight Americans
"A progressive form of non‐alcoholic fatty liver disease (NAFLD) known as non‐alcoholic steatohepatitis (NASH) can lead to cirrhosis and all its complications. Two studies investigated the effectiveness of potential treatments for NASH, one assessing pentoxifyline, a commonly used TNF╬▒ antagonist, as well as a separate analysis of pioglitazone, an insulin sensitizer, compared to vitamin E".

The doctors lounge published this article : ACG: Non-Alcoholic Fatty Liver Disease Tied to Heart Disease "Non-alcoholic fatty liver disease (NAFLD) appears to be associated with a high prevalence of coronary artery disease (CAD), and inflammatory bowel disease (IBD) appears to be an independent risk factor for CAD, according to two studies presented at the annual scientific meeting of the American College of Gastroenterology, held from Oct. 15 to 20 in San Antonio".

GalMed Medical begins phase-II trial of Aramchol to treat NAFLD & NASH conditions

October 18, 2010 13:00

GalMed Medical Research, a leader in research and development of products for the treatment of chronic lipid and liver related diseases, has initiated the multi-centre phase-II clinical trial with its proprietary.

Read complete story ...(You will need to login first to read this story.)

Fatty Liver In Hepatitis C: Genotype 1

Oct 20, "Steatosis and insulin resistance (IR) are frequent findings in patients with Genotype 1 HCV. Prior studies indicate that these metabolic features not only are independently associated with the severity of liver damage, but also are negative predictors of sustained virologic response (SVR) after standard antiviral therapy. ( Worth reading )
Genotype 3
In people with hepatitis C genotype 3 its believed that hepatitis C can actually cause fatty liver. Scientists have found that people with genotype 3, who reach SVR during therapy have a reduction and sometimes a complete reversal of fatty liver.

Other Information On This Blog: Oct 2010/ Fatty Liver Disease, Genotype 3, Vitamin E and HCV

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