Steatohepatitis is a condition in which fatty build-ups in the liver cause inflammation and liver damage. Initially, it may be asymptomatic, but people may experience fatigue, abdominal pain, and jaundice as it progresses.

Steatohepatitis can arise from alcohol consumption or during the course of certain health conditions, such as hypertension and type 2 diabetes.

Treatment for steatohepatitis typically involves lifestyle changes. This can include weight management, increased physical activity, and changes in diet.

This article takes a detailed look at the types of steatohepatitis, including their symptoms and causes. It also discusses risk factors, treatment options, and how to prevent the condition.

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Steatohepatitis is an advanced stage of fatty liver disease in which the liver builds up fat in irregular quantities. This leads to inflammation and sometimes liver damage.

There are two main forms of steatohepatitis:

According to a 2020 report, it is possible to have both forms of steatohepatitis. Doctors and researchers may call this “both alcoholic and nonalcoholic steatohepatitis (BASH).”

People with either type of steatohepatitis can have no symptoms for extended periods, although some may experience discomfort and pain in their abdomen. As the inflammation worsens, further symptoms may develop.

According to the American Liver Foundation (ALF), symptoms may first occur after a person develops cirrhosis, which is extreme liver scarring. Symptoms of NASH with cirrhosis may include:

People with NASH may have an enlarged liver and changes in pigmentation at the joints.

Excessive alcohol consumption can cause ASH. This occurs in around 20–40% of people with fatty liver who drink excessive amounts of alcohol.

In contrast, researchers associate several health conditions with NASH. These include:

According to the ALF, less common causes of NASH include:

According to a 2020 review, risk factors for NASH include:

  • insulin resistance
  • obesity
  • dyslipidemia
  • increased weight around the abdomen
  • excessive sugar and carbohydrate consumption

The risk of developing steatohepatitis may also increase with age.

Since steatohepatitis is typically asymptomatic in the early stages, doctors often diagnose it when treating a person with a different condition or performing routine bloodwork.

Further diagnosis may include:

To distinguish between NASH and ASH, doctors may need to assess a person’s history of alcohol consumption. They may also analyze the liver biopsy, as liver damage can look quite different for each condition.

The main treatment option for steatohepatitis is lifestyle modification. When treating NASH, doctors may recommend:

  • aiming for a weight loss of at least 5–10% through exercise and calorie reduction
  • increasing omega-3 fats in the diet
  • reducing certain sugars in the diet
  • consuming caffeinated drip coffee
  • supplementing with vitamin E

Abstinence from alcohol is also an essential element of managing ASH.

Liver transplantation is typically a last resort.

Steatohepatitis is a later stage of liver disease. According to a 2022 article, the outlook for steatohepatitis is good when the condition is not too advanced. Management through healthy lifestyle changes may help reverse some of the damage due to liver inflammation.

However, steatohepatitis can transform into cirrhosis, an even later stage of liver disease. Cirrhosis is irreversible scarring of the liver that may occur in around 20% of people with steatohepatitis.

The above article suggests that the 90-day mortality rate ranges from 1.9–71.3% depending on a person’s age and the severity of the condition.

Some risk factors for steatohepatitis may be within an individual’s control. By avoiding these risk factors, individuals may be able to lower their risk of developing this condition. The following tips could help to prevent steatohepatitis:

Steatohepatitis is often asymptomatic in the earlier stages, so people may not know to speak with a doctor. However, abdominal pain and fatigue can be signs to seek help.

If a person has abnormal liver function test results or imaging reveals fatty liver, a healthcare professional should assess their risk of progressing to liver scarring.

If a person is concerned about their liver health or associated conditions, such as type 2 diabetes, they may speak with a healthcare professional to help detect steatohepatitis at an early stage.

Steatohepatitis involves the inflammation of the liver and is a form of liver disease. It arises when there is too much fat in a person’s liver. Over time, the inflammation can cause damage, potentially leading to scarring of the liver.

Lifestyle changes are the main treatment for people with NASH or ASH. This may include eating a balanced diet, exercising regularly, and limiting alcohol intake. These management techniques can also help to prevent steatohepatitis.

Both forms of steatohepatitis can be symptomless. However, people may experience abdominal pain, fatigue, and other issues as the condition progresses. Anyone with symptoms of steatohepatitis should seek a doctor’s advice.