Surfing the MASH Tsunami

S3-E40.4 - Challenges of Alcohol Screening in Fatty Liver Disease


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As the NASH pandemic grows in the number and diversity of patient cases, one patient group receiving increased notice includes patients with "lean NASH," those with "normal" BMI levels (BMI<23 for Asians; BMI<25 for other racial groups). Last month, Gastroenterology published Best Practice recommendations for diagnosing and treating lean NASH. In this conversation, co-authors, Drs. Michelle Long and Mazen Noureddin join Louise Campbell and Roger Green to discuss Best Practice #6, which focuses on alcohol screening with lean NASH and really ANY patient who might have Fatty Liver disease.

This conversation starts with Louise Campbell pointing to Best Practice #6, querying patients routinely regarding levels of alcohol consumption. She points out that many patients will not provide an honest answer. Mazen points out that, unlike obese patients, with lean patients, the physician has to check every realistic alternative to lean NASH, and alcohol is certainly one of these. He agrees that patients might not always provide accurate answers. The conversation follows along on the challenges of alcohol questioning until Roger asks the final question. You need to listen to this conversation to hear what the various panelist had to say.

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