Fat can sometimes accumulate in the liver. Most often it is due to obesity, but it can also occur in people with certain health conditions, such as diabetes or high cholesterol, or people who take certain medicines. Sometimes fat accumulates in the liver without causing injury; this is called hepatic steatosis or non-alcoholic fatty liver disease (NAFLD).
In some patients, however, the fat damages the liver, causing inflammation and scarring. This is called nonalcoholic steatohepatitis (NASH). Researchers are still trying to figure out why this liver damage occurs. Though rare, it can lead to cirrhosis, even in children.
The underlying cause of NASH is unknown. Risk factors include the following health conditions:
A child who has a risk factor for NASH will not necessarily develop the condition. Likewise, a person with NASH may not have any of these risk factors. Research indicates that insulin resistance (when the body does not respond to insulin) may be an underlying factor. NASH affects between two percent and five percent of the population.
Symptoms of nonalcoholic steatohepatitis include right upper abdominal pain in some people. Most people with fatty liver usually do not experience symptoms and do not know they have NASH.
If your child experiences abdominal pain or routine blood work shows elevated liver enzymes, a pediatric gastroenterologist will perform exams and tests to help make a diagnosis, including:
There is no specific treatment for NASH. Your child's pediatric gastroenterologist may make the following recommendations, depending on your child's situation:
Sometimes, the doctor may recommend taking a vitamin E supplement, which can improve the symptoms of NASH.
The Riley at IU Health Liver Support Group meets one or two times a year for a family-oriented education program and socializing. Topics include testing for liver disease, complications of liver disease, impact of chronic disease on the family, liver transplant, nutrition for liver disease and medicine for liver disease.
Visit the websites below to find support groups and services and learn more about nonalcoholic steatohepatitis.
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
This website provides information about NASH, including patient stories.
This website from the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition provides education and information for parents and families living with NASH.
This website from the National Institutes of Health offers extensive information about the symptoms of and treatments for NASH, including information about research and clinical trials.
Our pediatric specialists participate in a multicenter research study investigating fatty liver disease and NASH. We encourage you to ask questions in order to make an informed decision about your child's participation in this study.
In addition to our primary hospital location at the Academic Health Center in Indianapolis, IN, we have convenient locations to better serve our communities throughout the state.