Medical and Surgical Treatment Options for Nonalcoholic Steatohepatitis

Dig Dis Sci. 2016 May;61(5):1387-97. doi: 10.1007/s10620-016-4083-8. Epub 2016 Mar 4.


Nonalcoholic fatty liver disease (NAFLD) is the most common cause of liver disease in the USA with a growing prevalence worldwide. Nonalcoholic steatohepatitis (NASH), progressive form of NAFLD, can lead to the development of cirrhosis, hepatocellular carcinoma, and the need for liver transplantation. Treatment of NASH may decrease the risk of progressive disease. Treatment for NAFLD should center around weight loss and exercise. Pharmacotherapy with vitamin E and pioglitazone should be considered for those with NASH, especially those with fibrosis. Weight loss surgery is also an effective treatment for NASH in individuals with other indications for surgery. In this review, we will discuss the currently available therapies for NASH including lifestyle, pharmacologic, and surgical options.

Keywords: Nonalcoholic fatty liver disease; Nonalcoholic steatohepatitis; Pioglitazone; Vitamin E; Weight loss surgery.

Publication types

  • Review

MeSH terms

  • Antioxidants / therapeutic use
  • Bariatric Surgery*
  • Exercise
  • Fatty Acids, Omega-6 / therapeutic use
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hypoglycemic Agents / therapeutic use*
  • Non-alcoholic Fatty Liver Disease / drug therapy*
  • Non-alcoholic Fatty Liver Disease / surgery*
  • Pentoxifylline / therapeutic use
  • Pioglitazone
  • Thiazolidinediones / therapeutic use*
  • Vitamin E / therapeutic use


  • Antioxidants
  • Fatty Acids, Omega-6
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Hypoglycemic Agents
  • Thiazolidinediones
  • Vitamin E
  • Pentoxifylline
  • Pioglitazone