Asking the right questions during visits with your doctor may help you get the information and support you need to manage your condition.
Nonalcoholic steatohepatitis (NASH) is now known as metabolic dysfunction-associated steatohepatitis (MASH). This new name is more accurate and helps reduce the stigma associated with its older name.
According to the American Association for the Study of Liver Diseases (AASLD), a group of multinational liver societies and organizations, including the AASLD, developed and finalized the name change and announced it in June 2023.
MASH is a type of metabolic dysfunction-associated steatotic liver disease (MASLD) that involves a buildup of fat, inflammation, and damage in your liver. It can get worse over time and may cause serious complications.
Learning to manage MASH is important to reverse the condition or stop it from getting worse.
Read on to learn questions to ask your doctor to get the information and support you need to manage MASH.
MASH can cause scarring in your liver, known as fibrosis. This scarring can make it harder for your liver to work properly and may cause serious complications.
There are
- Stage 0: There is a buildup of fat in your liver but no fibrosis.
- Stage 1: There is mild fibrosis in your liver.
- Stage 2: There is moderate fibrosis in your liver.
- Stage 3: There is advanced fibrosis, or a lot of scarring in your liver.
- Stage 4: There is cirrhosis, which is the most severe form of fibrosis.
Cirrhosis can cause liver cancer or liver failure, which are life threatening conditions.
That’s why it’s so important to follow your doctor’s prescribed treatment to manage MASH and liver limit damage.
Talk with your doctor to learn:
- how much damage and scarring you have in your liver
- whether it’s possible to reverse the damage and scarring
- what steps you can take to reverse it or stop it from getting worse
It’s sometimes possible to fully reverse MASH, particularly in the early stages.
It’s rare to fully reverse cirrhosis, although certain lifestyle changes and treatments may still improve your outlook if you develop this complication.
Your doctor may order multiple tests to diagnose MASH,
- blood tests to evaluate your liver function and check for signs of disease
- imaging tests to check for fat buildup, damage, or scarring in your liver
- a liver biopsy to collect a sample of liver tissue to examine under a microscope
Your doctor will order follow-up tests after diagnosing MASH to monitor your condition.
They may also order tests to check for signs of other health conditions, such as cardiovascular disease and type 2 diabetes. These conditions are
Talk with your doctor to learn:
- which tests you should get
- how often you need to repeat each test
- what each test involves and where to get it
- how to prepare for the test ahead of time
- how long it will take to get your test results
- what your test results mean
You may need to schedule a follow-up appointment to discuss your test results.
Your doctor will likely advise you to lose weight and make healthy lifestyle changes to reduce fat buildup, inflammation, and damage in your liver.
It might be possible to fully reverse MASH through weight loss and healthy lifestyle changes alone, particularly if you have no fibrosis or only mild to moderate fibrosis in your liver.
Your doctor may prescribe the medication resmetirom (Rezdiffra) to treat MASH with moderate to advanced fibrosis. This is currently
Rezdiffra is not recommended for people with decompensated cirrhosis, which is advanced cirrhosis that causes your liver to stop working properly.
Talk with your doctor to learn more about your treatment options, including the potential benefits and risks of different treatments.
Let your doctor know if:
- you’re finding it hard to lose weight or make lifestyle changes
- you think you may be experiencing side effects from treatment
- you have questions or concerns about your treatment
Your treatment options may change if your condition gets better or worse or new treatments become available.
Healthy lifestyle habits may help reverse MASH or stop it from worsening. Healthy habits may also lower your risk of complications and other health conditions that are more common in people with MASH, such as:
- cirrhosis
- liver cancer
- liver failure
- cardiovascular disease
- type 2 diabetes
Talk with your doctor to learn more about the specific lifestyle changes you can make to help manage your condition and improve your overall health.
For example, your doctor
- adjust how many calories you eat
- increase or limit certain foods in your diet
- take or avoid certain supplements
- limit or avoid alcohol
- avoid tobacco
- get more exercise
- get enough sleep
- manage stress
Let your doctor know if you’re finding it hard to make lifestyle changes. They may refer you to another specialist or share resources to help you.
Your primary care physician or family doctor will likely refer you to a hepatologist to treat MASH. A hepatologist is a type of doctor who specializes in liver disease.
You might also find it helpful to connect with other healthcare professionals or specialists, such as:
- a registered dietitian who can help you make changes to your diet
- a fitness specialist who can help you adjust your exercise routine
- a weight loss specialist who can help you lose weight
- a mental health specialist who can help you manage the emotional or social challenges of living with a chronic health condition such as MASH
Your treatment needs may change if you develop complications from MASH, such as liver cancer or liver failure.
It’s also important to get treatment for any other health conditions you may have, such as cardiovascular disease or type 2 diabetes. These conditions are more common in people with MASH.
Talk with your doctor to learn which healthcare professionals can support your treatment goals.
Let them know if you’re finding it hard to follow your treatment plan or need more support.
Scientists are continuing to develop new treatments and strategies for managing MASH. They use clinical trials to study experimental treatments and management strategies to learn how safe and effective they are.
Your doctor may encourage you to enroll in a
Experimental treatments may or may not be beneficial. They may also have unknown risks that researchers have not yet identified. Talk with your doctor to learn whether there are any clinical trials they would recommend for you.
You can also learn about current clinical trials by visiting ClinicalTrials.gov.
You can talk with your doctor or researchers from a clinical trial to learn whether you’re eligible to take part and what the potential benefits and risks may be for you.
Connecting with other people who have MASH may help you cope with the challenges of this condition.
You can talk about your experiences together and share strategies or resources that you’ve found helpful for managing MASH.
Consider asking your doctor whether there are support groups they would recommend.
You can also visit the American Liver Foundation (ALF) to:
- find links to national and online support groups
- check for local support groups or other resources in your state
- learn about the ALF’s peer-to-peer support program, Caring Connections
Following your treatment plan is essential for improving your outlook with MASH.
Weight loss, healthy lifestyle habits, and sometimes medication may help reverse MASH or stop it from getting worse. The condition becomes harder to reverse as it gets more severe.
Cirrhosis or other complications can worsen your outlook with MASH. According to a
Talk with your doctor to learn more about your outlook and the steps you can take to improve your condition or stop it from getting worse.
MASH is a condition that involves fat buildup, inflammation, and damage in your liver. It can cause scarring that may get worse over time and lead to serious complications.
Attending regular checkups with your doctor is important for managing MASH. They may order tests to learn whether your condition is getting better or worse.
Your doctor may recommend weight loss, lifestyle changes, and sometimes medication to help manage your condition. You may need additional treatments if you develop complications from MASH.
Talk with your doctor to learn more about the tests and treatments that you need to manage your condition. Ask them whether there are any other health professionals who can help support your treatment goals.
You might also consider taking part in a clinical trial to receive an experimental treatment for MASH.
Connecting with others through a support group or peer-to-peer program may also help you manage the challenges of this condition. Your doctor can help you learn more about these resources and others.