NASH with enlarged spleen

   I have been diagnosed with NASH for about 5 years now.  At my last liver biopsy (5 years ago), I was told I was a stage two in terms of fibrosis.  Recently I went to my Dr. with upper right back pain that wrapped around the the right side abdomen.  I had blood work done and enzymes for liver were high as expected.  I believe AST's were 59 and ALT's were 89.  An ultrasound was also scheduled.  Before my ultrasound could take place, the pain began to move to the feft side.  Now, I have a great deal of pain in my whole abdomen and where my spleen is.  Ultrasound found spleen enlarged to 15cm.  Is this related to NASH or could I have another underlying issue.  Thanks, Tom

[Paderla Anitha, DNB]

Hello and hope you are doing well.

NASH can progress to cirrhosis of liver. This scaring of the liver can cause portal hypertension, which is increased pressure in the portal veins and back flow, resulting in splenomegaly, , which is an increase in size of the spleen, caused by congestion of the red pulp as a result of portal hypertension. Controlling portal hypertension will help with splenomegaly.

Hope this helped and do keep us posted.