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NASH and Cirrhosis

At their very root, non-alcoholic steatohepatitis (NASH) and cirrhosis are two medical conditions that affect the liver. However, this seemingly separate duo shares more in common than you may think. When NASH and cirrhosis get together, your liver is at the heart of their destruction. Knowing their similarities and how they differ is part of the ongoing education slowing a growing epidemic for our liver and overall health. What is NASH? NASH is the most severe form of non-alcoholic fatty liver disease (NAFLD). NAFLD is an umbrella term for various diseases that cause excess fat accumulation in the liver. Many individuals with NAFLD have a simple fatty liver without any complications. On the other hand, around 25% develop NASH. NASH is the chronic inflammation of the liver triggered by the immune system after enough fat accumulation. Over time, chronic inflammation starts to damage and scar the liver, leading to cirrhosis, liver cancer, and liver failure. What is Cirrhosis? Cirrhosis is a chronic, long-term condition where scar tissue replaces healthy liver tissue. Viruses like hepatitis, alcohol abuse and NAFLD like NASH are the most common causes of cirrhosis. In regards to NASH, the damage from chronic inflammation comes from the body’s healing response continuing when it’s meant to stop once repairs are complete. Instead of eliminating excess repair supplies like collagen, it continues depositing it. This results in fibrous scar tissue that spreads across and stiffens the liver. Without treatment, cirrhosis can lead to loss of liver function and progress to liver cancer and liver failure. A Growing Epidemic NAFLD is the most common chronic liver condition in the U.S. At the current rate, health experts expect NASH prevalence to increase 63% by 2030. Because most people don’t know they have NASH, we can only estimate how many individuals have it. While even the estimations can be scary, it’s never too late to get your liver health back on track. Many factors fuel NASH. However, obesity, diabetes, and other conditions caused by unhealthy lifestyle choices are among the most common causes. By knowing your risk for NASH, you and your provider can begin regularly monitoring your liver, and you can make healthier lifestyle changes. Together, these can significantly positively impact the progression and prevention of liver disease. Prioritizing Your Liver Health May be Easier Thank You Think! Prioritizing your liver health doesn’t have to be overwhelming. Arizona Liver Health has options to help you get started. Do you know you’re at risk for liver disease but haven’t gotten checked out? No problem! We offer a FREE fibroscan for adults at risk of liver disease that can quickly and painlessly determine your liver health. We also conduct clinical research studies to help expand care options for individuals living with liver disease. So, if your fibroscan results indicate the presence of a liver condition, our team will talk with you about enrolling study options that may help! Click on the links above to learn more, or call us today at (480) 470-4000. Sources: https://www.the-nash-education-program.com/what-is-nash/how-prevalent-is-nash/ https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/definition-facts https://www.hopkinsmedicine.org/health/conditions-and-diseases/chronic-liver-disease-cirrhosis#:~:text=The%20most%20common%20causes%20of,triglycerides%2C%20and%20high%20blood%20pressure) https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis/symptoms-causes

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Can you stop cirrhosis before it occurs?

Catch Cirrhosis from The Start

Cirrhosis of the liver is a progressive disease, developing slowly over many years. If allowed to continue, the buildup of scar tissue can eventually stop liver function. Because of the gradual decline, liver cirrhosis often goes undetected and unnoticed. You can potentially catch cirrhosis from the start by knowing the signs and your risk for liver disease. The Silent Organ The liver is known as a silent organ because when symptoms of liver disease become apparent, it is typically in the later stages of the disease. If you’re at increased risk of liver disease, you can work with your doctor for annual screenings and lifestyle changes to protect your liver. Risk factors include: Chronic alcohol abuse Chronic viral hepatitis (hepatitis B, C, and D) Fat accumulating in the liver (nonalcoholic fatty liver disease) Being overweight Insulin resistance Family history Signs of Cirrhosis Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions. Each time your liver is injured, it tries to repair itself. This process causes the formation of scar tissue. As cirrhosis progresses, more scar tissue forms, eventually making it difficult for the liver to function (decompensated cirrhosis). While the damage done by cirrhosis generally can’t be undone, if diagnosed early and the cause is treated, further damage can be limited and, rarely, reversed. As scar tissue accumulates, the ability of the liver to function properly is affected. The following signs and symptoms may occur: Blood capillaries become visible on the skin on the upper abdomen. Fatigue Insomnia Itchy skin Loss of appetite Weight loss Nausea Pain or tenderness in the area where the liver is located Red or blotchy palms Weakness If you’re looking to get your liver health back on track, Arizona Liver Health can help. After all, liver health is in our name. We offer FREE fibroscans for adults at risk of liver disease to test for liver fat and fibrosis, which may lead to cirrhosis and liver failure. We also provide an opportunity to participate in one of our enrolling clinical trials to help advance the treatment of liver diseases for those with liver disease. To learn more, call us at 480-470-4000, or visit us online today! Sources: https://www.webmd.com/digestive-disorders/understanding-cirrhosis-basic-information https://www.medicalnewstoday.com/articles/172295#treatment https://www.mayoclinic.org/diseases-conditions/cirrhosis/symptoms-causes/syc-20351487    

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Know the stages of cirrhosis

From Liver Disease to Cirrhosis

Cirrhosis is when the permanent scarring of the liver has replaced the healthy tissue. While cirrhosis is most often associated with chronic alcohol consumption, it is brought about by many types of liver disease. Here’s how you get from liver disease to cirrhosis. Inflammation to Fibrosis When you have liver disease, the liver enters into a perilous cycle to heal itself. The immune system sends the signal to repair cells triggering chronic inflammation and to continue depositing collagen. In a healthy liver, the collagen stiffens around the tissue, and any extra is discarded. However, with liver disease, there is no signal to stop the inflammation discarding the excess collagen. So, the inflammation and more deposits of collagen continues. This leads to more liver stiffening and the development of fibrosis. Fibrosis is when collagen and other proteins build up between the cells. This forms scar tissue which can block or limit blood flow within the liver, eventually starving and killing healthy liver cells. More scar tissue forms, and unlike healthy liver cells, it cannot function or repair itself. Fibrosis to Cirrhosis While fibrosis is reversible even into the later stages of liver disease, there is a point where the damage is too significant, and the liver can’t fix itself. No treatment can cure cirrhosis; by staying away from things that could harm your liver further, like liquor, certain drugs, and fatty food, you can help improve some of the scarrings. Treatment for individuals with cirrhosis includes managing its symptoms and treating the underlying cause to prevent liver function from worsening or liver failure. Those with cirrhosis have a high risk of developing liver cancer and eventually needing a transplant. Our livers are versatile, continuing to work even when they’ve become seriously scarred. Most individuals with liver disease do not know it until routine blood work picks it up or symptoms become present in the later stages. Talk with your doctor about preventative measures you can take if you’re at risk of liver disease. Arizona Liver Health offers FREE fibroscans for adults at risk of liver disease. A fibroscan is a quick way to determine the health of your liver and the presence of liver disease. Should your results indicate fatty liver or other liver conditions, our staff will talk with you about enrolling studies that may be an option. To learn more, call us at (480) 470-4000, or fill out a request form online today! Sources: https://www.webmd.com/digestive-disorders/understanding-cirrhosis-basic-information https://liverfoundation.org/for-patients/about-the-liver/the-progression-of-liver-disease/#cirrhosis-severe-scarring

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Late stage of liver scarring: cirrhosis

A Complication of Liver Disease: Cirrhosis

Cirrhosis is the replacement of healthy liver tissue with non-living scar tissue. It is a complication of liver disease from the progressive damage caused if not treated. Most people have no symptoms in the early stages, where the progression has the greatest chance of being reversed. If you are at risk for liver disease, the time to act is now. What Causes Cirrhosis? Cirrhosis is the result of chronic inflammation and swelling that scars the liver. It can take many years to get to this stage. Many different liver diseases can progress to cirrhosis. However, the most common ones are Hepatitis C, Alcohol-related Liver Disease (ARLD), Non-Alcoholic Fatty Liver Disease (NAFLD), and Hepatitis B. In general, alcohol addiction and obesity are risk factors that can predispose you to liver disease and, ultimately, cirrhosis. NAFLD is the most common liver disease where fat accumulates in the liver and eventually can progress to liver failure. Insulin resistance, family history, metabolic syndrome, sedentary lifestyle, and chronic consumption of foods high in calories and fat are risk factors for NAFLD. Cirrhosis Stages The progression has 4 stages. The stage also determines whether the liver is compensated or decompensated. Compensated means the liver can still perform most of its essential functions despite scarring. Decompensated means the scarring now prevents the liver from functioning properly. Stage 1– Some scarring of the liver, but no complications and few symptoms. Stage 2– Blood flow through the liver becomes blocked, and pressure increases inside it. Enlarged veins that are a result of the added strain. Fatigue, itching, loss of appetite, fluid retention in legs, and bruising are more symptoms. Stage 3– The liver scarring becomes advanced, and the abdomen swells. Possible liver failure and serious complications can occur. This stage marks the transition into decompensated cirrhosis. Yellowing of the eyes and skin, brain fog, slurred speech, redness of the palms of hands, and internal bleeding are other symptoms. Stage 4– End-stage liver disease can develop, which is fatal if a transplant is not found. Early Detection and Treatment The liver is an amazing organ that can regenerate itself. Even with some scarring, the liver can heal itself well into the later stages when caught and treated. Cirrhosis has no cure. Though, by addressing any underlying conditions, making healthier lifestyle changes, and medications to control symptoms, patients can manage the progression. If you’re at risk, talk with your doctor. Arizona Liver Health conducts free fibroscans that can detect diseases of the liver such as NAFLD and NASH. Once results are ready, our medical staff will help you determine if additional steps are needed. If your results indicate abnormal liver function, our team will discuss enrolling studies for the liver that may be an option. Schedule your FREE fibroscan today! Request an appointment here. References: https://liverfoundation.org/for-patients/about-the-liver/diseases-of-the-liver/cirrhosis/#information-for-the-newly-diagnosed https://www.medicinenet.com/cirrhosis/article.htm https://www.webmd.com/digestive-disorders/understanding-cirrhosis-treatment#2

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