Liver Cirrhosis with Steatohepatitis: Nonalcoholic Steatohepatitis and Alcoholic Steatohepatitis

Abstract

Nonalcoholic steatohepatitis is a phenotype of metabolic diseases in the liver, associated with eating disorders and lack of exercise. In contrast, alcoholic steatohepatitis develops due to alcohol abuse. Although the causes are different, each type of steatohepatitis exhibits the same histological features, such as steatosis, lobular and portal inflammation, hepatocellular ballooning, and perisinusoidal and pericellular fibrosis. Untreated nonalcoholic and alcoholic steatohepatitis can progress to cirrhosis, and advanced fibrosis is a predictor of poor prognosis. Therefore, it is important to elucidate the pathophysiology and make appropriate diagnoses and initiate treatment. Various factors are involved in each pathological conditions. To diagnose these diseases, a more user-friendly diagnostic assessment is needed. Currently, predictive models combined with several indicators and imaging assessments are used. Further, several treatments are attempted for patients in clinical practice and clinical trials, however the efficacy is not sufficient. In this chapter, we reviewed the epidemiology, pathophysiology, diagnosis, and treatment of cirrhosis due to both nonalcoholic and alcoholic steatohepatitis.