The role of comorbidities in NASH management: a holistic approach

So when you take care of patients with NASH (non-alcoholic steatohepatitis), you have to consider not only the liver but really the patients so you have to have a holistic approach with these patients. Clearly you have to know how far they are in their liver disease; you have to have the diagnosis of NASH. But from what are these patients dying? They are dying from cardiovascular problems. They are dying from cancer and not liver cancer necessarily. So you have to know if they have causal risk; smoking, diabetes and all that. You need to address and treat hypoglycemia with steatin, a good drug for the liver also. And you have to see if they are at risk for colorectal cancer. 

What can patients  and healthcare professionals do? 

So these patients need to have colonoscopy regularly, women need to have mammograms to also screen for breast cancer. So these patients have different traits that you need to take into account which is an important aspect. That’s especially if you want to talk about lifestyles with these patients; to talk about their anxiety and depression many of these patients are actually depressed. They’re not very mobile. They don’t use their social networks often. 

They don’t get out of their home and they are very limited and this is an important aspect to discuss with them. Ask them to get a dog, because when you have a dog you are forced to walk with a dog and your dog will meet other dogs. And so you will speak with the owner of the other dog. So you will meet people and you have to get out but in order to do that, you have to be sure that your patients would have too many joint pains and these patients often have knee pains. So you have also to see what drugs they are taking for their pain. See how you can improve their life so that they might be more mobile. So other than yes, you have to consider a holistic approach when you take care of patients with NASH.