Next step after NASh diagnosis

[Rick6776]

50 yo male who was exposed to volitile compounds in military at camp Lejeune. I'm not obese, not a drinker, normal triglycerides, no diabetes and all other liver disease rulued out. Had ultrasound with fatty liver and elevtaer liver enzymes, repeat Ultrasound 5 years later now shows increased fatty liver and hepatomegaly, Nash firosure test came back probable NASH. What should be next step? Any further test? Thank you

[nash2 Partner]

Hi Rick

You likely have advancing fibrosis but it is important to know how much fibrosis you have. The next step in terms of cost would be to get a FibroScan which gives you a measure of liver stiffness. If possible work with a liver doc as primary care docs often don't know much about liver disease. It is common to have no symptoms before you become a cirrhosis patient. It is wise to try to not get to that point.

[Rick6776 in reply to nash2]

Thank you very much for your quick reply. Is the fibroscan similar to an ultrasound or CT. I will definitely look into it and get that done thank you again

[nash2 Partner in reply to Rick6776]

Hi Rick

FibroScan is a specialized ultrasound that measures fat and stiffness of the liver. A normal ultrasound or a CT don't measure liver health well. Few understand that an ultrasound can't detect fatty liver until it is at least 30% fat. It may be hard to find a Fibroscan as most docs don't use them yet.

[swanlw45]

Hi I am new to this site. Dx'd in about 1990 with elevated enzymes which are now normal. Had bx of liver showing fatty liver as has on ultrasound. Back then no info given of any kind in what to do. Thought just something I knew was there . Did have cholecystectomy after that for folded sluggish GB, nausea & vomiting. Had a fibroscan recently which shows fibrosis of liver F 3 (advanced) and fatty liver S3 (mod to severe). GI Dr ordered Upper rt ultrasound and said he usually does every 6 mos if cirrhosis but at this stage I do not have cirrhosis so he thinks it will be annual. The only advice he had for now was to lose weight. I have a BMI about 35 and have lost weight before but always slowly goes back up. Due to my age 74, and having Idiopathic Pulmonary Fibrosis dx'd May, 2018, no meds not oxygen, I have increased my activities/exercise but cannot do as I would have been able to when younger. He said the IPF and liver fibrosis are not related. The reason he wants ultrasound is to watch for any further disease process, such as cancer. Have hx of rt breast cancer 2003 followed by radiation and Tamoxifen. No chemo. Also have been on meds for GERD for about 40 yrs. I think increasing my exercise and nutritional lifestyle is what I need to do. Only rare alcoholic drinker but should stop that completely too. Sorry such a long reply. Meant only to tell you my GI Dr told me today results of fibroscan and for known cirrhosis pts he has them get ultrasound every 6 months.