Treatment of NASH with Gastric Bypass

Curr Gastroenterol Rep. 2018 Sep 22;20(10):49. doi: 10.1007/s11894-018-0653-6.

Abstract

Purpose of review: Nonalcoholic steatohepatitis (NASH) is a spectrum of nonalcoholic fatty liver disease (NAFLD). It is defined as the presence of fatty liver along with inflammation and hepatocyte injury. To date, weight loss achieved via lifestyle intervention remains the mainstay of NASH treatment. However, given the known benefit of weight loss on NASH and the known effect of bariatric surgery on weight loss, several studies have explored the potential role of bariatric surgery on the treatment of NASH.

Recent findings: This review article summarizes the evidence on the effect of Roux-en-Y gastric bypass (RYGB), a common bariatric surgery, on NASH therapy. Specifically, studies show that RYGB is associated with an improvement of all NASH histologic features at 1 year. Compared to adjustable gastric band, RYGB appears to be superior at treating NASH. Randomized controlled trials and long-term studies are underway to better clarify the role of these procedures specifically for NASH therapy.

Keywords: Bariatric endoscopy; EBMT; Fatty liver; Gastric bypass; NAFLD; NASH; Obesity; RYGB.

Publication types

  • Review

MeSH terms

  • Bariatric Surgery
  • Endoscopy, Gastrointestinal
  • Gastric Bypass*
  • Humans
  • Non-alcoholic Fatty Liver Disease / surgery*