MASLD and MASH

What MASLD and MASH are

MASLD is fat stored in the liver, together with a metabolic condition such as excess weight, type 2 diabetes, high blood pressure, or high triglycerides. Alcohol is not the cause. The older name is NAFLD.

In some people the liver becomes inflamed. That stage is called MASH. The older name is NASH. Inflammation can injure liver cells, and over time that injury can scar the liver. Advanced scarring is called cirrhosis.

Many people have no symptoms. The condition is often found on a blood test or a scan done for another reason.

Symptoms and complications

Many people feel nothing. When changes do appear, a person may notice:

• Tiredness or weakness
• A dull ache or fullness under the right ribs
• Loss of appetite
• Unexplained weight loss
• Yellow skin or eyes
• Swelling of the belly or legs
• Confusion or unusual sleepiness

Yellow skin, swelling, and confusion are more often signs of advanced scarring. Vomiting blood, or black stools, needs emergency care. If you have urgent symptoms, call 911 or go to an emergency department.

Diagnosis and tests

Blood tests can show liver irritation and can help estimate scarring. They do not prove MASLD or MASH by themselves.

Ultrasound can show fat in the liver. FibroScan, shear wave elastography, or MRI elastography estimates stiffness. A higher stiffness number is a sign of more scarring. Some of these tests also estimate fat.

A liver biopsy takes a small tissue sample. It is used when the other results do not give a clear answer. Your family doctor arranges imaging. A clinician reads the tests together, and no single result sets a treatment plan on its own.

Treatment and management

Care usually starts with weight, physical activity, and control of diabetes, blood pressure, and cholesterol. A dietitian visit can help with the eating plan.

Alcohol can injure the liver further. Ask the clinician how much, if any, is reasonable.

A clinician may discuss medicine or another treatment. This page does not name a drug or a dose.