Engaging one's PCP in a conversation about risk for MASH liver disease doesn't have to be scary.
Categories: For Potential Participants, [Nonalcoholic Steatohepatitis (NASH), Diabetes complications, Fatty liver disease, Lifestyle changes]
MASH, formerly known as NASH, has been described as the most common disease you’ve never heard of. It stands for metabolic dysfunction-associated steatohepatitis. It’s hard to pronounce, harder to learn you are at risk. MASH is a serious form of fatty liver disease called metabolic dysfunction–associated steatotic liver disease (MASLD, which you have probably never heard of, either). Both conditions develop over time with very few symptoms. Believe it or not, MASLD (formerly called NAFLD) affects two billion people around the world, most of whom are already managing other medical conditions like diabetes, heart disease and/or weight issues. If that sounds like you or a loved one, it’s important to learn more about risk and MASH.
MASLD is a condition in which there is a buildup of fat in a liver. This process happens quietly. Over time, this buildup damages the liver. MASH occurs when ongoing inflammation leads to scarring (“fibrosis”) of the liver. This makes it harder for the liver to function effectively. And MASH that is unmanaged and progresses over time can lead to even more serious disease such as cancer.
Most MASH patients are middle-aged, receiving care related to diabetes, and carrying extra weight. For a person already living with other medical conditions, adding a new problem to the list – especially if it’s not causing any pain – is a tough sell. But as with so many things, knowledge is power.
Why has my doctor not talked to me about MASH?
There are many possibilities why MASH is not a more routine part of the doctor-patient conversation for at-risk patients. COVID has been very disruptive to primary care and reduced in-office visits for weight checks and physical observation. Additionally, when it comes to MASH and risk, the best defense is a good offense: exercise and weight loss. A doctor that has already counseled a patient to lose weight for other reasons may not be sure what else to do.
What else is there?
A PCP deals with a broad range of medical issues and can’t be expected to know everything. A PCP should however help write the patient’s playbook. For someone ready to talk about MASH and personal risk or worry, a PCP can help in many ways once the patient has started, or accepted, the dialogue:
English (USA)