Brief back story: about 2 years ago I had what I thought was a gallbladder attack. I went to the ER because I couldn't stop throwing up and my stomach hurt really bad. They did tests, and said it's most likely my gallbladder. They recommended an ultra sound that my PCP at the time wouldn't give me. Fast forward to last month. I had 2 more short what I thought were gallbladder attacks again in the same day. So I went to the ER, they took some blood, gave me some fluids, and scheduled me an ultra sound for the next day when I told them my old PCP wouldn't schedule me one. I got the ultra sound done. My gallbladder is fine. My liver is enlarged twice the size it's supposed to be. More blood tests later and my new PCP (who I like, she seems really nice) emails me this: "I think the liver changes are due to nonalcoholic hepatosteatosis (also known as "fatty liver.") The best thing you can do is diet and exercise for weight loss."

This is Kaiser's explanation of NASH:

This is what I expected it was. I started googling as soon as I heard my liver was enlarged. I google a lot. And I found a couple interesting articles/pages. There seem to be mixed reviews for whether surgery is helpful or harmful.

The websites I've read said that there are two types of fatty liver disease. Non-alcoholic Fatty Liver Disease (NAFLD) and Non-alcoholic Steatohepatitis (NASH), and that the only way to tell which one you have is by a liver biopsy. I haven't had one of those done, so I'm wondering if my doctor is correct. I don't want to say she's not since she's the doctor, not me. But who needs a medical degree when you have the internet? When I think about it, NASH fits because my liver is enlarged, and in NASH there is inflammation.

Having read that wls may not be good, it made me worry a little. So I played phone tag on Thursday with the bariatric department and they said I could still have the surgery. But I'm still skeptical and nervous. I'm nervous b/c of the reduction of food and wondering if I can really do this, plus I don't want to get all the way to surgery for them to poke me to find out my liver isn't ok to get the surgery done. I want to know for sure that my liver is ok before I get to that point so there isn't any, go home and try again later.

And then there's my family. The only people who know I have liver disease are my doctor and my boyfriend. My family keeps asking if I got any results about my gallbladder and I keep telling them I'm still waiting. I know I should tell them, but I feel embarrassed, ashamed. I don't want a bunch of questions about it. I don't want to have to explain that my having liver disease is the result of being fat and eating badly. I can't imagine it ending well. I don't know what to do. Any advice?

Here are links to the websites I've read and a few quotes:

http://www.digestive.niddk.nih.gov/ddiseases/pubs/nash/

-The only means of proving a diagnosis of NASH and separating it from simple fatty liver is a liver biopsy.

-Weight loss can improve liver tests in patients with NASH and may reverse the disease to some extent.

http://en.wikipedia.org/wiki/Non-alcoholic_fatty_liver_disease

-A biopsy (tissue examination) of the liver is the only test that is widely accepted as definitively distinguishing NASH from other forms of liver disease,

-gradual weight loss may improve the process in obese patients; rapid loss may worsen NAFLD. The negative effects of rapid weight loss are controversial: the results of a meta-analysis showed that the risk of progression is very low.

-A recent meta-analysis presented at the Annual Meeting of American Association for Study of Liver Diseases(AASLD) reported that weight-loss surgery leads to improvement and or resolution of NASH in around 80 % of patients

http://www.mayoclinic.com/health/nonalcoholic-fatty-liver-disease/DS0057

http://www.emedicinehealth.com/fatty_liver_disease/article_em.htm

-The definitive diagnosis of fatty liver disease can only be confirmed by liver biopsy

-In patients who are morbidly obese, bariatric surgery to promote weight loss is very effective in decreasing liver inflammation and NASH.

http://www.uptodate.com/contents/patient-information-nonalcoholic-steatohepatitis-nash

-Although other tests may suggest a diagnosis of NASH, liver biopsy is required to confirm it.

-Weight reduction can help to reduce levels of liver enzymes, insulin, and can improve quality of life. Weight loss should be gradual (no more than 3.5 lbs or 1.6 kg per week) since rapid weight loss has been associated with worsening of liver disease.

http://www.liverdisease.com/nonalcoholicfattyliver_hepatitis.html

-Excessively rapid weight reduction or starvation techniques can actually worsen or even precipitate progression to cirrhosis and liver failure.

Has anyone here had / have NASH and had the surgery? Have anything to say about it?