John Damianos, M.D. Profile picture
@MayoClinicGIHep Gastroenterology & Hepatology Fellow. Yale Internal Medicine, Dartmouth Med. 🦠Microbiome, brain-gut axis, diet, IBS, IBD, motility, #MedEd🇬🇷

Oct 24, 2021, 16 tweets

A case!

⚠️11% of patients with incidentally discovered steatosis may be at risk for advanced hepatic fibrosis!

Don't ignore patients with incidentally found steatosis!

Determining degree of fibrosis: NAFLD fibrosis score and FIB-4 are easy, noninvasive, and useful!

Treatment of #NAFLD

Note metformin is ABSENT, since it's NOT an effective therapy for NAFLD!

WEIGHT LOSS is 🔑

7-10% of body weight loss ▶️ 50% regression of liver scarring/fibrosis

> 10% ▶️ >80% regression!!!!

Vitamin D may protect against hepatic inflammation

Vitamin E is recommended in patients with biopsy proven #NASH, except in patients with diabetes.

✅GLP-1 analogues

✅Statins should be given to ALL patients with NASH/NAFLD. They are SAFE even if elevated liver chemistries!!!

✅Coffee! ☕️ ☕️ ☕️ ☕️ ☕️ ☕️ ☕️ ☕️

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