Hello there,
This is my first post and I have been reading the forum posts about two years, always containing helpful advice. I would have one question to ask, I have NASH and fibrosis on stage 2. My gastroenterologist has told me nothing to worry and he has discharged me and is asking to come back two years later for fibroscan. Is this common or should they keep checking on progression for NASH and fibrosis more frequently?
Hi
First, welcome to this wonderful forum of kind caring,compassionate and supportive people.
I would have thought 2 years is a long time. I was diagnosed with fatty liver in May 2016 which was caused by meds from my drs over the years. Then 6 months later I was diagnosed with Nash after having a biopsy. My consultant carried on seeing me every 6 months unless I wasn't well or bloods showed something, then I would be seen sooner. Anyway, I saw my consultant last October who referred me for a fibroscan, I think he did this to shut me up!! The fibroscan showed I had compensated cirrhosis ,
The liver nurse who spoke to me after my scan said I needn't worry too much as it was compensated. I'm only saying what happened to me, please don't think you will get cirrhosis. I know many people have reversed it. Take care and stay safe Lynne
Hi,
If you are in the UK you may be interested in the NICE guidance for Non Alcohol Related Fatty Liver Disease
nice.org.uk/guidance/ng49/i...
We would suggest to also discuss any concerns regarding follow up if you have NASH with your own clinical consultant
Best wishes.
A gastroenterologist isn't a liver specialist. The gastroenterologist I saw told me that people with liver issues represented a small minority of patients he has. Most patients he saw were for things like checking for bowel cancer etc. If you only had fatty liver the gastroenterologist would be correct telling you not to worry but if you have NASH & it goes unchecked it could eventually progress to cirrhosis. If you follow his advice & do nothing & come back in 2 years you could find that you have more fibrosis & are further down the path to getting cirrhosis.
NASH is not harmless. It is a liver disease with the potential to cause cirrhosis (as unfortunately happened to Oldham65). The only way to determine if you have NASH as opposed to fatty liver (which is benign) is a biopsy. I'd request a referral to a hepatologist who specialises in liver disease and if he confirmed that you have NASH then you should be monitored while doing everything possible to stop it.
The reason why you developed NASH should be identified if possible. Was it due to alcohol, drugs (prescribed or otherwise), fatty liver or some undiagnosed condition? NASH caused by drinking or drugs should be able to be stopped by not drinking or drugging. NASH caused by fatty liver can be difficult if not impossible to stop. It can be addressed by lifestyle changes such as losing weight if you are overweight, exercising, diet etc. and these may be enough to stop it or at least reduce its severity & speed of progression.
Thank you for everybody for their responses. I am based in London and my NASH is caused by fatty liver. The gastroenterologist who advised not to bother specialises in obesity. I was puzzled about his advice as it does not seem to be in line with NICE guidance. I had liver biopsy in February and it was not benign but do not leave the fibrosis un-treated. The same consultant told me previously that most patients fail to make any lifestyle adjustments in terms of weight, his view did seem to be that condition is self-inflicted, and is to be managed by the patient. I have already lost weight but still suffer abdominal pain and inflammation. My own GP referred me originally due to abnormal LFD’s and agreed that she cannot necessarily treat the condition for me. I suppose I will have to complain to the Trust in order to be seen earlier than 2 years.
In view of your consultant's attitude it may not be worth seeing him more often. While it's true that you are the one that needs to make the lifestyle changes it would be helpful to have encouragement from a consultant who could order periodic blood tests and a FibroScan every 12 months to check the fibrosis. If you changed consultants the next one might be no better. In your situation I'd do all I could in terms of lifestyle changes to try and switch the NASH off & ask my GP to do a blood test every 3 or 6 months.
Hi I wouldnt wait 2 years ---I was diagnosed with fatty liver and wasnt seen for two years within 2 weeks i was given a biopsy and diagnosed with top end of stage 2 Nash had I known how dangerous fatty liver can be I would have changed lifestyle and prob not progressed to Nash
Good afternoon,
You have had good advice from fellow forum members - you shodul not have to wait 2 years before having a review. is your GP involved in monitoring you at all ?
regards
Thanks, not really. Although my GP during routine check up noticed that I had severe D vitamin defiency and my ALT levels were high. My GP at first assumed that ALT levels increased as D vitamin defiency caused some form of inflammation. Even when my D vitamin levels returned back to normal, the ALT levels remained and that’s why GP referred me to see GI team at NHS Trust based in Central London. I have daily pain on the right hand side where the liver is, and will rely on self-care and asking my GP to check the LFD’s. The NICE guidelines are not necessarily helpful in terms of follow up’s as the guidelines notes that clinical practice varies so I assume each GI consultant will take a different view, and some will like my own consultant just ask to come back two years later. That period is long and would assume I would reverse the NASH which I don’t think I can do. The best I probably can do is to slow the progress whilst trying to be more healthy.
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NASH Trial
Cirrhosis/Nash?
