Who Treats Nonalcoholic Steatohepatitis (NASH)?

If you have recently been diagnosed with nonalcoholic steatohepatitis (NASH), you might wonder who will manage your treatment. Understanding the healthcare professionals involved can help you navigate your journey to better liver health.

Managing NASH and other liver diseases requires a team of healthcare professionals. Each brings their expertise to ensure that you get comprehensive care.

Primary care providers

Your primary care provider (PCP) is often the first point of contact for any health issue. Your PCP may be a doctor, nurse practitioner, or physician assistant.¹

Your PCP will conduct a physical exam, medical history, and possibly other tests like blood tests. Depending on what they discover, they may refer you to a specialist.¹

Hepatologists

Hepatologists are doctors who specialize in liver diseases. They have expert knowledge about the liver and extra training in diseases that affect the liver. Hepatology is a subspecialty of gastroenterology, which focuses on the digestive system. Hepatologists are a vital part of a NASH healthcare team.^1,2

Your PCP may refer you to a hepatologist if:^1,3

• Your blood tests show elevated liver enzymes
• Your liver is enlarged (usually noticed during a physical exam or with imaging tests)
• You have symptoms that suggest liver problems

Hepatologists provide advanced NASH care and can help manage the liver transplantation process if necessary. They work closely with other specialists to ensure comprehensive care.^1,2

Endocrinologists

Endocrinologists are doctors who specialize in hormones and metabolic disorders. NASH is often linked with metabolic conditions, and endocrinologists play a key role in managing them. They can help form treatment plans for people with diabetes, obesity, or metabolic syndrome. These are all comorbidities that can worsen liver function.^4,5

Nurses

Nurses support people with NASH (and their families) in many ways, including:⁶

• Educating people with NASH and their families about their condition
• Coordinating care between specialists
• Monitoring liver health
• Giving treatment
• Providing clinical support
• Offering follow-up care

Nurses may work in a doctor's office, hospital, or transplant center. They also may work for a home health agency. Generally, they help people learn to understand and manage NASH and other health conditions.⁶

Dietitians and nutritionists

The first step toward managing NASH is to make diet and lifestyle changes. Registered dietitians and nutritionists are experts in nutrition. They can help create personalized eating plans that support liver health.^7,8

These experts also provide guidance on weight management and balanced nutrition. They help people avoid certain foods or drinks that may harm the liver. Their support is valuable in helping people adopt sustainable, healthy habits.^7,8

Surgeons

In severe cases where liver damage is extensive, surgery may be necessary. Types of surgery for NASH range from managing complications to liver transplantation.^9,10

Because obesity is a risk factor for developing NASH, weight loss surgery may be an option. Bariatric surgeons perform weight loss surgeries, such as gastric bypass. This type of surgery can lead to significant long-term weight loss. A reduction in body weight can help decrease liver fat, inflammation, and liver scarring (fibrosis).¹⁰

If you need a liver transplant, a transplant surgeon will be a part of your healthcare team. Transplant surgeons specialize in these complex operations. They are part of a multidisciplinary team in transplant centers. This means they work closely with hepatologists and other medical experts throughout the transplant process. They also help manage postoperative care.⁹

Psychologists and mental health experts

Living with a chronic liver disease like NASH can be emotionally challenging. Research shows that people with NASH have higher rates of depression, anxiety, and other mental health conditions.¹¹

Mental health professionals include psychologists, counselors, and therapists. These experts provide support for those living with NASH. And if you need a liver transplant, you will visit a psychiatrist. They will determine whether you are mentally and emotionally healthy enough for the surgery.^9,11

Addressing mental health is a crucial part of holistic care. Counseling can help people maintain a positive outlook and stick to treatment plans.¹¹