NASH: the symptoms

The problem with this disease is that it is most often a chance discovery. Steatosis and uncomplicated NASH of cirrhosis are most often asymptomatic.

Indeed, the diagnosis is often made during a blood test. It shows disturbances of the hepatic evaluation with hepatic cytolysis and / or an increase in Gamma GT and an increase in ferritinemia.

Sometimes there is diabetes right away with high fasting blood glucose or high cholesterol.

There may be heaviness in the right hypochondrium (right upper part below the ribs) associated with hepatomegaly (an increase in the size of the liver). This hepatomegaly is palpable by the doctor and must be confirmed by a liver ultrasound which will also visualize the existence of steatosis (fatty infiltration of the liver).

In case of advanced form of NASH with cirrhosis, the symptoms are those of cirrhosis and are nonspecific: it may be only fatigue and / or loss of appetite.

In case of a more advanced form, jaundice with yellow eyes and dark urine may appear and indicate liver dysfunction.

There are biomarkers of fibrosis as well as prognostic score to identify patients at low risk of advanced fibrosis / cirrhosis.

Elastometry is also a good tool for evaluating these patients. In case of significant risk, it is important to confirm the existence of NASH and the degree of fibrosis by performing a liver biopsy puncture.

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