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Non-alcoholic steatohepatitis (NASH) is a type of hepatitis which resembles alcoholic hepatitis on liver biopsy (fat droplets, inflammatory cells, but usually no Mallory's hyalin) but occurs in patients who have no known history of alcohol abuse. Best bronchoscopy NASH is more common in women and the most common cause is obesity or the metabolic syndrome. Best bronchoscopy A related but less serious condition is called "fatty liver" (steatosis hepatis), which occurs in up to 80% of all clinically obese people. Best bronchoscopy A liver biopsy for fatty liver shows fat droplets throughout the liver, but no signs of inflammation or Mallory's hyalin. Best bronchoscopyThe diagnosis depends on history, physical exam, blood tests, radiological imaging and sometimes a liver biopsy. Best bronchoscopy The initial evaluation to identify the presence of fatty infiltration of the liver is radiologic imaging including ultrasound, computed tomographic imaging, or magnetic resonance imaging. Best bronchoscopy However, radiologic imaging cannot readily identify inflammation in the liver. Best bronchoscopy Therefore, the differentiation between steatosis and NASH often requires a liver biopsy. Best bronchoscopy It can also be difficult to distinguish NASH from alcoholic hepatitis when the patient has a history of alcohol consumption. Best bronchoscopy Sometimes in such cases a trial of abstinence from alcohol along with follow -up blood tests and a repeat liver biopsy are required. Best bronchoscopyNASH is becoming recognized as the most important cause of liver disease second only to Hepatitis C in numbers of patients going on to cirrhosis. Best bronchoscopy

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