Don't Drink Alcohol? You Could Still Get Fatty Liver Disease
Metabolic dysfunction-associated steatohepatitis (MASH) can occur when too much fat accumulates in the liver, leading to scarring and liver failure. Here's what you need to know.
By Ashraf Malek, MD, FAASLD, FACP, Hepatologist, Virtua Advanced Transplant & Organ Health
Drinking too much alcohol can take a serious toll on your liver health. But did you know you can get liver disease without drinking alcohol?
Metabolic dysfunction-associated steatohepatitis (MASH), a type of fatty liver disease, can occur when excess fat accumulates in the liver, causing chronic inflammation and the buildup of scar tissue called fibrosis.
Once you have fibrosis, you have a high probability of cirrhosis—which prevents the liver from working normally—liver failure that requires a transplant, or cancer.
What Are the Causes of MASH?
About the size of a football, the liver is located under your rib cage on the right side of your abdomen. As part of its role in the digestion process, the liver metabolizes fat and carbohydrates (which can turn into fat).
When there is too much excess fat, the liver becomes overwhelmed and toxic. This can initiate the inflammation that leads to fibrosis and scarring.
MASH shares many of the risk factors that also cause cardiovascular disease, including:
- Eating foods high in saturated and trans fats
- Type 2 diabetes
- Metabolic syndrome
- Obesity
- High blood pressure
- High cholesterol
- High triglycerides
- Underactive thyroid
- Polycystic ovarian syndrome
- Obstructive sleep apnea
What Are the Symptoms of MASH?
It’s estimated that one in 20 American adults lives with MASH, with many unaware they have it. That number is expected to increase significantly over the next five years.
MASH does not produce clear symptoms, if any, so it is often not detected until it has progressed to later stages. That’s why it’s sometimes referred to as a silent disease. Those later-stage symptoms may include:
- Upper right abdominal pain
- Fatigue
- Nausea
- Appetite loss
- Yellowing of the skin and eyes (jaundice)
- Fluid build-up and swelling of the legs
Diagnosis of MASH is typically made through a physical exam, bloodwork, and transient elastrography (FibroScan), which uses ultrasound to reveal the level of scarring and fat within the liver.
What Are the Most Effective Treatments for MASH?
Treatments for MASH at Virtua include:
- Resmetiron, a drug that can slow or reverse scarring in the liver
- GLP-1 weight-loss drugs or bariatric surgery
- Lifestyle changes such as eating a Mediterranean-style diet, exercise, and avoiding alcohol.
Why You Should Be Tested for MASH
If we can catch MASH early enough, we can slow down or even reverse the fibrosis and reduce the amount of inflammation and fat in the liver. Working with our colleagues in bariatrics, endocrinology, and cardiology, we can treat the conditions that contribute to MASH, like obesity, diabetes, and high lipid and blood pressure levels.
Virtua Delivers the Liver Care You Need
If you have any of the risk factors for MASH, like diabetes, obesity, or high blood pressure, speak to your primary care provider about screening. Virtua’s multidisciplinary metabolic liver disease program provides the latest treatments, including liver transplantation. Call 888-847-8823 to make an appointment with a Virtua liver specialist.
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