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For a liver biopsy, a needle is inserted through the skin to remove a small piece of the liver. NASH is diagnosed when examination of the tissue under the microscope shows fat along with inflammation and damage to liver organs cells. If there is fat without inflammation and damage, simple fatty liver or NAFLD is diagnosed. An important piece of information learned from the organs biopsy is whether scar tissue has developed in organs the liver. Currently, no blood tests or scans can reliably provide this information. [Top] Symptoms NASH is usually a silent disease with few or no symptoms. Patients generally feel well in the early stages and only begin to have symptoms—such as fatigue, weight loss, and weakness—once the disease is more advanced or cirrhosis develops. The progression of NASH can take years, even decades. The process can stop and, in some cases, reverse on its own without specific therapy. Or NASH can slowly worsen, causing scarring or "fibrosis" to appear and accumulate in the liver.
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