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Vitamin E and ursodeoxycholic acid have shown improvement in specific populations. Surgical Care: Bariatric surgerySeveral studies are emerging that indicate that bariatric surgery with appropriate weight loss results in both chemical improvement and histologic improvement of NASH.Early studies reporting possible worsening hepatic sirosis function after rapid weight loss have not been substantiated. This may be a viable option in the appropriate candidate.Consultations: The only way to firmly diagnosis NASH is with a sirosis liver biopsy. Often, a clinical picture of obesity, hypertriglyceridemia, and elevated transaminases is enough to conclude that a patient has NASH. However, sirosis underlying alcohol or other drug ingestion as well as smoldering autoimmune or hemochromatosis must be ruled out. Referral to a hepatologist with or without liver biopsy may help in staging and prognosis.Diet: Abstinence from alcohol may reverse steatosis in patients with alcohol-related fatty liver.Based
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