Steotohepatitis is the inflammation of the liver due to the over accumulation of fat in the liver. This disease is also known as the fatty liver acid disease and is common amongst alcoholics. It is also frequently observed among obese persons and those who have diabetes and other metabolic syndromes. The accumulation of fat in the liver is caused by drinking too much alcohol and eating too much fatty foods. However, there are also cases where a person who is diagnosed with steotohepatitis has not consumed a lot of alcohol or fat laden food, and who is neither obese nor diabetic. There are two types of steatohepatitis, namely alcoholic steatohepatitis and non-alcoholic steatohepatitis.
Non-alcoholic steatohepatitis or NASH is a rare disease because while most people have fat in their liver, most do not show signs of their liver swelling, and yet in certain individuals the fat causes the liver to swell. The reason why this happens is still unknown, but some doctors theorized that this may be due to the genetic makeup or that the person is diabetic or obese. Another possible cause may be high cholesterol levels or other metabolic problems. Most people suffering from NASH are between 40 and 50 years old, but there are cases where kids are diagnosed with NASH.
Unfortunately, there is no specific way to diagnose NASH. To know whether a person has NASH, he has to go to a doctor or a specialist to undergo an abdominal ultrasound, a scan, a MRI or even a biopsy. The symptoms can only be seen when the disease is already in advanced stages. Also, NASH can progress and develop into cirrhosis or fibrosis in the liver which is life threatening and irreversible. So, it is better to detect the disease in earlier stages so it can be treated immediately, so that further advancement of the disease can be avoided.
Alcoholic steatohepatitis is a liver disease caused by too much consumption of alcohol. The alcohol kills the cells in the liver thereby destroying the function of the liver as well. It is common among people who drink everyday for five years or longer. The kind of alcohol is irrelevant; instead the purity of alcohol is the culprit. Actually a 60 to 80 ml of pure alcohol per day for men and 40 to 50 ml of pure alcohol per day for women is toxic to the body. Also more women develop alcoholic steatohepatits than men.
There are three types of alcoholic steatohepatitis. The first type is alcoholic fatty liver, where the liver is enlarged, firm and has turned into a pale yellow color. The second type is alcoholic hepatitis, where fibrosis is observed in the liver. There is also an inflammation caused by the hepatitis virus and the liver feels tender to the touch. The third type is alcoholic cirrhosis, the end stage liver disease where lumps have formed in the liver so that is can no longer function normally. Most people suffering from alcoholic cirrhosis have a life expectancy of only one to three years.
People suffering from non-alcoholic steatohepatitis can exhibit symptoms like jaundice or yellowing of the skin. They can also exhibit easy bruising, swelling of the lower abdomen, itching skin, poor memory or confusion and vomiting of blood. However, these symptoms can only be observed when NASH is already in its advanced stage.
On the other hand, a person with alcoholic steatohepatitis also exhibits nausea, vomiting, jaundice, swelling and tenderness in the abdomen. However symptoms like fever and encephalopathy is unique to alcoholic steatohepatitis. Encephalopathy is a condition where a person experience confusion, altered consciousness and even coma. Also steatohepatitits can increase blood pressure which may cause sudden bleeding. This can be life threatening when not diagnosed immediately.
Steatohepatits has three grades: mild, moderate and severe. It is graded according to the amount of fat in a single cell. When the accumulation of fat in the cell is big enough to distort the cytoplasm and the nucleus, the event is called macro-vesicular steatosis, while the opposite is called micro-vesicular steatosis. Mild grade steatohepatitis is characterized by the presence of macro-vesicular steatosis. Also the hepatocyte – the liver cell, exhibits occasional swelling. Moderate grade on the other hand, has micro-vesicular and macro-vesicular steatosis. And the hepatocyte exhibits obvious swelling which means the liver is inflamed. In the severe grade, both micro-vesicular and macro-vesicular steatosis is present in more than 66% of the liver cells. Swelling hepatocyte is dominant and the liver exhibits fibrosis and chronic inflammation.
Steatohepatitis Treatment Options
As of now, there is still no definitive treatment for steatohepatitis. Most treatment includes dieting, exercise and lifestyle changes. For non-alcoholic steatohepatitis caused by obesity, diabetes, high cholesterol, high pressure and other metabolic syndrome, the treatment is done by curing the underlying disease. If a person is obese or has high cholesterol, that person is treated with a diet regime and an exercise program. The treatment is designed to lower the fat in the liver and thereby eliminating steatohepatitis. To hasten the removal of fat in the liver, antiglycemic drugs can also be used. NASH is difficult to diagnose and if not treated immediately, can develop into cirrhosis.
The first treatment for alcoholic steatohepatitis is the elimination of alcohol consumption. Most patients diagnosed with alcoholic steatohepatitis are just in the early stage so it is easy to treat. However, if the patient is already in the advanced stage there are no drugs that can cure the disease. Liver transplant is the last treatment option for those who are already in the end stage.