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Nonalcoholic Steatohepatitis (Nash)
At GastroDoxs in Houston, Dr. Scott specializes in diagnosing and treating nonalcoholic steatohepatitis (NASH). Combining advanced imaging, personalized lifestyle plans, and the latest medical therapies, he delivers comprehensive, patient-centered, expert care to prevent liver damage and improve long-term health outcomes.
Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.
What Is Nonalcoholic Steatohepatitis (NASH)?
Nonalcoholic Steatohepatitis (NASH) is an advanced form of nonalcoholic fatty liver disease (NAFLD), where excess fat buildup in the liver causes inflammation and damage. Unlike liver disease caused by alcohol, NASH occurs in people who drink little or no alcohol. It is commonly associated with obesity, type 2 diabetes, high cholesterol, and metabolic syndrome. Many patients have no symptoms until the disease progresses, but some may experience fatigue, abdominal discomfort, or liver enlargement. If left untreated, NASH can lead to cirrhosis, liver failure, or liver cancer. Early diagnosis through imaging and blood tests allows for interventions like lifestyle changes, weight loss, and medications to slow or reverse liver damage.
Common Causes and Risk Factors
Obesity or overweight
Insulin resistance and type 2 diabetes
High cholesterol or triglycerides
Metabolic syndrome
Rapid weight gain or weight loss
Family history of liver disease
Signs and Symptoms
Often none in early stages
Tiredness or weakness
Mild pain or fullness in the upper right belly
Unexplained weight loss
Swelling in legs or abdomen (advanced disease)
How Dr. Scott Diagnoses This Condition?
Dr. Scott uses a step-by-step approach:
Medical History and Exam
He reviews your symptoms-especially epigastric pain, fatigue and any abdominal discomfort-along with alcohol use, medication history and metabolic risk factors.
Blood Tests
We check liver enzymes (ALT, AST), lipid panels, fasting glucose/HbA1c and rule out other causes of liver injury (viral hepatitis, autoimmune disease).
Imaging Studies
Ultrasound: Evaluates hepatic echogenicity to detect fatty infiltration.
FibroScan or elastography: Measures liver stiffness as a noninvasive assessment of fibrosis.
Advanced Testing (if needed)
Occasionally, a liver biopsy or MR elastography is performed to confirm diagnosis, stage inflammation and gauge fibrosis severity.
Treatment
Our Team offers a full range of care for Nash.
1. Lifestyle and Diet Changes
Stop or lower NSAID use - switch to safer pain-relief options
Eat small, frequent meals to reduce stress on your gut
Add gentle fiber sources like oats and bananas to soothe the intestine
Stay well hydrated with water, broths, and electrolyte-rich fluids
2. Medications
Proton pump inhibitors (PPIs) to lower acid and protect the gut lining
Sucralfate or similar barrier agents to coat and heal injured areas
Probiotics to restore healthy gut bacteria and support recovery
3. Minimally Invasive Procedures
Balloon dilation to open and relieve strictures in the small intestine
Endoscopic cautery for targeted sealing of bleeding sites without surgery
Capsule retrieval procedures if a diagnostic capsule becomes lodged
Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.
Frequently Asked Questions
What causes Nonalcoholic Steatohepatitis (NASH)?
NASH is caused by fat buildup in the liver that leads to inflammation and damage. Common risk factors include obesity, insulin resistance, type 2 diabetes, and high cholesterol.
How is NASH different from fatty liver disease?
Simple fatty liver (NAFLD) involves fat in the liver without inflammation. NASH is a more severe form, where fat buildup triggers liver cell injury, scarring, and possible long-term complications.
Can NASH be reversed?
Early-stage NASH can often be reversed with lifestyle changes such as weight loss, healthier eating, and exercise. Advanced stages may require medication or specialized care.
What are the symptoms of NASH?
NASH is often silent in early stages. Some patients may experience fatigue, abdominal discomfort, or signs of liver dysfunction as the disease progresses.
How is NASH diagnosed?
Diagnosis may involve blood tests, liver ultrasound or FibroScan, and sometimes a liver biopsy to confirm inflammation and fibrosis.
Are there medications for NASH?
While no single FDA-approved drug exists specifically for NASH yet, Dr. Scott may use off-label therapies, enroll patients in clinical trials, or recommend targeted medications to manage risk factors and reduce inflammation.
Do I need regular monitoring?
Yes. Patients with NASH require ongoing liver monitoring through imaging and blood tests to track liver health and prevent progression to cirrhosis.
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