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What is Steatohepatitis?

By D. Jeffress
Updated May 17, 2024
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Steatohepatitis is a form of liver disease in which fatty deposits accumulate in the liver and cause tissue inflammation. The condition is most common in people who abuse alcohol, though it can also manifest because of obesity, diabetes, or an inherited metabolic disorder. Most cases of steatohepatitis do not cause any negative physical symptoms. If the condition goes unnoticed, however, it can lead to cirrhosis or eventual liver cancer. In order to reduce the risk of permanent liver problems, doctors usually suggest that patients abstain from alcohol and develop healthy diet and exercise habits.

Fat tends to build up in the liver when the body is unable to break down fatty acids from food. Years of alcohol abuse can significantly impair metabolic functioning. Conditions like diabetes, morbid obesity, severe malnutrition, or glycogen storage disease also lead to fatty liver deposits. The presence of fat in the liver triggers an immune system response in an attempt to combat the foreign substance. The result is persistent irritation and inflammation of surrounding liver tissue.

Steatohepatitis rarely causes symptoms in its earliest stages. As inflammation worsens, an individual may experience abdominal pain and feelings of fatigue. Over time, irritated liver tissue can become scarred and lead to a liver disease called cirrhosis. Some instances of steatohepatitis progress to a deadly form of cancer known as hepatocellular carcinoma.

Since steatohepatitis is asymptomatic, a doctor may not notice the condition until a patient is screened for a different health problem. If a routine test reveals fat in the liver, a physician typically orders a number of other tests to make an accurate diagnosis. Computerized tomography scans, x-rays, and ultrasounds can reveal the extent of inflammation and tissue damage. A surgeon may extract and analyze a piece of liver tissue to confirm the diagnosis.

Treatment for steatohepatitis tends to be focused on eliminating the underlying cause. Patients are usually instructed to avoid alcoholic drinks and maintain healthy diet and exercise routines. Some people are prescribed medication to lower their cholesterol and promote healthy metabolic activity. Additional drugs or insulin injections may be needed in the case of diabetes. A full recovery is likely when steatohepatitis is discovered early and the patient follows his or her doctor's orders.

Surgery is usually reserved for instances of severe steatohepatitis that do not respond to lifestyle changes or medicine. Bariatric surgery is a procedure that is performed on morbidly obese patients to reduce the capacity of their stomachs, thereby helping them lose weight and take strain off of their livers. It is sometimes necessary for a surgeon to actually cut out fatty buildups in the liver and mend the healthy tissue back together to prevent cancerous tumors from forming. Following surgery, regular checkups are important to ensure that the patient experiences a full recovery.

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