Difference between fatty liver and nash? - British Liver Trust

British Liver Trust

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Difference between fatty liver and nash?

Porphyriamaniac profile image

Hi, i was diagnosed with a fatty liver via ultrasound. I was just wondering if anyone knows if dr can differentiate between nafld and nash via this means? How is nash diagnosed? Do symptoms differ between the two? should i ask dr for further tests? All bloods were ok except alt slightly raised at 66 and insufficient vit d. My symptoms are severe fatigue and just 'not feeling good/right'.


Stacie. X

14 Replies

Check out the British Liver Trust page on NAFLD / NASH and it may help with some of your questions. britishlivertrust.org.uk/li...

Thanks, i will have a look. X


Good morning Stacie,

Now that you have been pointed in the direction of the British Liver Trust website, you should have a better understanding of your diagnosis.

Hopefully any damage to your liver isn't too bad and recovery entirely possible.

Maintaining good general health by keeping to a good balanced diet, low on salt/sodium and sugar, plenty of exercise and little or no alcohol, will all contribute to helping you and your liver.

There is plenty of information on how to achieve all of this on the BLT website and of course following and contributing to this forum will help you get the right kind of support to stay well.

Take care,


Thanks grace x

Hi jim, thanks for reply. I hope its not beyond redemption either! 😊 i will let you know what dr says. I am trying with the diet and the booze, the exercise, thats another matter 😁 i am too tired after work most of the time but i will try and fit some in. Some of the threads on here are very sobering though, literally. Needs must!

Take care

Stacie. X


I understand completely what you mean about being too exhausted for even thinking about exercise.

When I was seriously ill, the physiotherapists at the hospital had to really 'bully' me into even walking. However, bit by bit I managed to get well enough to withstand the transplant surgery. Don't be put off by my story, a transplant is at the extreme end of liver disease. You have been given an early warning and a chance to change things around. Be positive.

Don't give up hope, take the stairs instead of a lift, get off the bus one stop early and walk the rest. It all helps.


I had the same diagnosis after an abdominal ultrasound almost 2 years ago! My report reads "mild diffuse fatty notation of the liver without focal lesion. There is no biliary ductal dilatation". I was very concerned but my doctor wasn't concerned even though my liver enzymes were slightly elevated! I was not educated about reversing it and it was never discussed again at my appointments? I tried to discuss my concerns with my doctor a few times but again nothing was educated to me about this other than it was mild? I decided to do my own research and started eating healthier, limit alcohol. I rarely drank anywhere now I drink maybe 1 time a year? I feel good and get an occasional pain in my right rib/back area if I eat wrong or drink soda?

I have Nash, I was diagnosed by biopsy. There are things they look for ballooning, inflammation etc. My US said my liver was 100% healthy, I also have PBC I'm stage 4 Cirrhosis. I don't trust US anymore.

Hi jim thanks for your positivity! 😁 im glad you are doing well, it is nice to hear good outcomes. I could do wth a 'bully' behind me to get me going 😁 i have quite an active job, it is just fitting a little more in on top of that. Im sure i will get there.

Take care, stacie. X

Hi leahnicole, yeah sounds really similar to me, my gallbladder was ok. I am back at gp on 6th sept, not a clue what will come of it! Glad you are feeling well though! Have they not been checking your bloods regularly or done another ultrasound then to see where its at?

Stacie. X

Hi rebegarcia10, that is a bit worrying...do you think i ought to ask for further tests? I.e. biopsy or fibroscan? My imflammation markers have been raised on occasion, no ballooning thankfully.

Thanks, stacie. X

The only way to be sure that you definitely have NASH is by biopsy, or, it used to be. That is how I was diagnosed. Ultrasound is practically useless as it can only pick up fatty liver but not which kind and not how bad it is. A fibroscan is much better.

Thanks splodge60 im considering fibroscan if bloods are off again. ☺

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