When fatty liver progresses into NASH with liver scarring, it’s often a missed or misunderstood diagnosis.
Too often, people know they have issues with “fatty liver” but get caught by surprise when they learn that dangerous liver scarring (fibrosis) has developed. The liver performs 500+ important functions (when it’s healthy), and we often take that for granted. But when the liver is damaged by NASH, a severe form of nonalcoholic fatty liver disease, there can be critical consequences.
A healthy liver performs
It’s common not to know your RISK.
43% of NASH patients say the risk of progressing to cirrhosis (severe liver scarring) was not explained to them at diagnosis.*
But the truth is … the risk of progression can have serious consequences.
1 out of 5
PATIENTS WITH ADVANCED FIBROSIS WITHOUT CIRRHOSIS PROGRESSED TO CIRRHOSIS AFTER APPROXIMATELY 2.5 YEARS†
†In a study of patients with biopsy-proven NASH, 48 of 217 patients (22%) with advanced fibrosis without cirrhosis progressed to advanced fibrosis with cirrhosis at around 29 months.
The first time I heard the word ‘NASH’ was the same day I was diagnosed with liver cirrhosis.”
If you have fatty liver, the truth is you may have liver damage due to NASH.
7 out of 10
NASH patients do not recall a discussion at diagnosis about the potential need for a liver transplant in the future.*
What is NASH?
If you’ve been told you have fatty liver, you may be at risk for something more serious called nonalcoholic steatohepatitis (NASH). NASH is a severe form of nonalcoholic fatty liver disease (NAFLD) where a buildup of fat in the liver damages liver cells, and the liver becomes inflamed (liver inflammation is called hepatitis). For many, NASH may progress to include scarring (liver scarring is called fibrosis). This scarring can prevent the liver from properly functioning.
A healthy liver performs more than 500 important functions, including cleaning toxins from blood, helping with energy production, storing vitamins and minerals, and helping digestion. When the liver doesn’t function well, there may be few or no obvious symptoms, but it can still be dangerous. If you do have symptoms, the most common sign is fatigue or a mild pain in the upper right abdomen.
Because NASH is usually a silent disease, it can progress for years—or even decades—undetected. Over time, the damage to the liver may become more severe, resulting in advanced fibrosis.
MANY PEOPLE ASSOCIATE LIVER DISEASE WITH ALCOHOL ABUSE. BUT THE TRUTH IS, MOST LIVER DISEASE TODAY IS CAUSED BY OTHER FACTORS, INCLUDING BEING OVERWEIGHT.
There is a stigma about the liver that is tied to alcoholism. I don’t drink, and this happened to me.”
You may be at risk for NASH if you have these health conditions.
TYPE 2 DIABETES
While a liver biopsy is considered the gold standard in diagnosing NASH, the procedure is not without risk. It can be painful for some and is also subject to errors because it only takes a small sample of the liver, which may or may not be representative of the entire organ. Besides a liver biopsy, there are several tests that can provide valuable information to help inform a NASH diagnosis. Liver function tests are blood tests that measure certain enzymes and proteins in the blood and are often used to diagnose or monitor liver disease or damage. Additionally, noninvasive screening technology, such as ultrasounds and other imaging tests, are becoming more widely used to measure the scarring in the liver.
Nonalcoholic fatty liver disease (NAFLD) can be broken down and classified into the following stages:
Left untreated, advanced fibrosis due to NASH can lead to serious complications, such as cirrhosis, liver cancer, liver failure, or ultimately death.
NASH is the fastest-growing reason for liver transplantation in the United States, and the supply of donor organs cannot keep up with the demand. NASH has already surpassed alcoholic liver disease and at its current pace will soon eclipse hepatitis C as the leading cause of liver transplants.
Without a medication to treat this disease, the number of people with advanced fibrosis is projected to double by 2030. Because the risk of negative outcomes increases as fibrosis progresses, there is an urgent priority to help those with advanced fibrosis from progressing to cirrhosis and other liver-related complications.
There are no approved medical treatments yet for people living with NASH. Today, NASH is largely treated by lifestyle changes designed to enhance weight loss, including diet and exercise.
Even if your doctor isn’t pushing you, THE TRUTH IS THAT YOU MAY BE AT RISK FOR REAL DANGER.
You’re going to need to be an advocate for yourself, for the future. Your treatment plan’s going to depend upon it.”
Currently, the only option to control NASH progression is to lose weight by adjusting diet and committing to exercise.
If you’re struggling with lifestyle changes,you’re not alone.
Only 25% of NASH patients feel they’ve been very successful at making lifestyle changes.*
If my liver can forgive me, then maybe I can forgive myself too.”
But the truth is … livers are quite resilient!
Losing 10% or more of your body weight can stabilize or decrease liver scarring (fibrosis).
My life changed when my hepatologist told us the things we needed to do to save my life. We started over with a diet that is healthy. As a result, I’m doing well and I’m probably not going to die of liver disease.”
Connect with groups who are empowering the NASH community through education, peer connection, and support.
YOU ARE NOT ALONE. IT’S COMMON TO FEEL IN THE DARK.
6 out of 10
NASH patients say there is simply not enough information available to them.*
But the truth is … support is available.
Despite all of these misperceptions about NASH, the good news is that your liver can be assessed by doctors, so you can know where you stand, and your risk of progression.
The most important part for me is that I’m a part of the team. I have a say in what’s going on in my health plan, and I want to have a voice in that.”
USE YOUR VOICE, DISCOVER YOUR TRUTH.
Knowing where you stand is an important step in your treatment plan, but navigating a conversation with your doctor about NASH can sometimes feel complicated.
Take action and download this simple tool that will help you start a discussion with your doctor about how to manage NASH and understand your risk of progression.
*The NASH TRUTH 2.0 Survey was conducted in the US from March 19 to April 25, 2019 by Ipsos. A total of 164 doctor-diagnosed NASH patients were interviewed online, recruited from a blend of online patient communities and patient databases. Quotas were applied to ensure all stages of NASH were included.KNOW YOUR RISK