NAFLD and NASH Diagnosis, Treatment and Cost

PACE Hospitals provides specialized non-alcoholic fatty liver disease (NAFLD) treatment in Hyderabad, India, offering personalized care for patients with NAFLD and NASH (Non-Alcoholic Steatohepatitis). This condition occurs due to fat buildup in the liver in people who consume little or no alcohol and can progress through different stages if untreated.


Our team ensures accurate NAFLD diagnosis using liver function tests, ultrasound, and FibroScan to assess severity. Treatment focuses on lifestyle changes, weight control, and medical management to prevent progression and improve overall life expectancy.

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Non-Alcoholic Fatty Liver Disease diagnosis inHyderabad, India

Diagnosis of NAFLD and NASH

The diagnosis of NAFLD and NASH is based on detecting fat in the liver in individuals who consume little or no alcohol and excluding other liver diseases. Blood tests, imaging studies, and clinical evaluation are all part of it. If NASH is suspected, further testing may be necessary to determine liver fibrosis and inflammation. 

Hepatologists (liver specialists) and gastroenterologists consider the following before selecting the appropriate NAFLD and NASH diagnostic tests:

  • Medical history
  • Physical examination

Medical history

A detailed medical history is important to identify risk factors and exclude other causes of liver disease in suspected NAFLD/NASH. The hepatologists and gastroenterologists may ask the following questions: 

  • Do you drink alcohol? If yes, how much and how often?
  • What medications, herbal supplements, or over-the-counter drugs are you currently taking?
  • Have you ever been diagnosed with hepatitis or any other liver disease?
  • Do you have conditions such as obesity, type 2 diabetes, high cholesterol, or high blood pressure?
  • Have you noticed symptoms such as fatigue, weakness, or discomfort in the upper abdomen?
  • Do you have a family history of fatty liver disease, diabetes, or metabolic disorders?
  • What are your daily habits related to diet, physical activity, and smoking?

Physical examination

During physical examination, the doctor checks for signs of liver disease and metabolic risk factors. This includes measuring body weight, body mass index (BMI), and waist circumference to assess obesity. The abdomen is examined to detect an enlarged liver or tenderness. The doctor may also look for signs of advanced liver disease, such as jaundice (yellowing of skin or eyes), swelling of the abdomen or legs, or skin changes. Blood pressure and general health status are also assessed as part of metabolic evaluation.

✅Diagnostic Evaluation of NAFLD and NASH

Based on the above information, hepatologists and gastroenterologists advise the diagnostic tests to detect NAFLD and NASH. The following includes the NASH and NAFLD diagnosis criteria:

Blood tests

  • CBP (Complete blood picture): Complete blood picture (CBP/CBC) is not a confirmatory test for diagnosing NAFLD or NASH, but it is recommended as part of the routine baseline evaluation. It helps assess overall health and is mainly used to calculate non-invasive fibrosis scores, such as FIB-4 and the NAFLD Fibrosis Score, using platelet counts. Decreased platelet levels may indicate advanced liver fibrosis or cirrhosis. Thus, CBP helps in the rule-out of the risks and staging of liver disease, but must be interpreted along with liver function tests, imaging, and clinical assessment.

  • Liver function tests: Liver function tests (LFTs) are a key part of the evaluation of NAFLD and NASH. LFTs usually show mild to moderate elevation of ALT (Alanine Aminotransferase) and AST (Aspartate Aminotransferase), with ALT often higher than AST in early NAFLD, while an AST predominance may suggest advanced fibrosis. Tests that can help in evaluating liver function and identifying problems include serum bilirubin, albumin, prothrombin time, and alkaline phosphatase. However, imaging and clinical risk factors must be used to interpret results because normal LFTs alone do not rule out NAFLD or NASH.

  • Viral hepatitis tests: Viral hepatitis tests are routinely done in patients suspected of NAFLD or NASH to rule out other causes of liver disease. Screening for hepatitis B and C is performed using blood tests such as HBsAg and anti-HCV antibody. If positive, confirmatory tests like HBV DNA or HCV RNA are performed. These tests do not diagnose fatty liver, but they help exclude viral hepatitis, which can also raise liver enzymes and cause liver damage, ensuring an accurate diagnosis and proper treatment plan.

  • Genetic and serology testing for celiac disease: Tests for celiac disease (an autoimmune disease of the intestine) may be done in some patients with suspected fatty liver (NAFLD/NASH) to check if another condition is affecting the liver. These are simple blood tests, such as tTG-IgA and EMA antibodies, which help detect celiac disease. In some cases, a genetic test (HLA-DQ2/DQ8) may be done to support or rule out the condition. These tests do not diagnose fatty liver itself, but they help doctors identify or exclude celiac disease so that the correct cause of liver problems can be treated.

  • Hemoglobin A1C (HbA1c) test: When evaluating patients with suspected NAFLD or NASH, the Haemoglobin A1c (HbA1c) test is recommended to screen for diabetes and insulin resistance, which are risk factors for fatty liver disease. The test helps detect prediabetes or diabetes by detecting the average blood sugar levels over the previous two to three months. HbA1c helps in risk assessment, disease severity evaluation, and management guidance, even though it does not directly diagnose fatty liver.

  • Lipid profile: The lipid profile is an important blood test in the evaluation of individuals with suspected NAFLD or NASH to assess cholesterol and triglyceride levels. Lipid testing is a part of the metabolic risk assessment for fatty liver disease. The test measures total cholesterol, LDL (bad cholesterol), HDL (good cholesterol), and triglycerides, which are often elevated in NAFLD. Although it does not diagnose fatty liver directly, it helps identify dyslipidemia (abnormal levels of fats), assess cardiovascular risk, and guide lifestyle and treatment planning in NAFLD/NASH management.

Blood-based Fibrosis Assessment 

  • Fibro test and APRI (AST-to-Platelet Ratio Index): In patients with suspected NAFLD or NASH, non-invasive blood-based tests called FibroTest and APRI (AST-to-Platelet Ratio Index) are used to determine the extent of liver fibrosis (scarring) without a biopsy. While FibroTest estimates liver damage by combining several blood markers, APRI is determined by AST levels and platelet count. These tests do not confirm fatty liver itself, but they help identify patients at risk of advanced fibrosis, guide further evaluation, and support appropriate treatment planning.

  • FIB-4 (Fibrosis-4) Index and NAFLD Fibrosis Score (NFS): The FIB-4 (Fibrosis-4) Index and NAFLD Fibrosis Score (NFS) are non-invasive, blood-based scoring tools recommended for assessing the risk of liver fibrosis in NAFLD/NASH. They are calculated using parameters like age, BMI, AST, ALT, platelet count, blood sugars, and albumin. These scores classify patients into low, intermediate, or high risk of advanced fibrosis, helping decide the need for further tests like FibroScan or liver biopsy.

Imaging tests

  • Abdominal ultrasound: Abdominal ultrasound is the first-line imaging test for diagnosing suspected NAFLD or NASH. It is a safe, simple and non-invasive scan that can detect accumulation of fat in the liver (hepatic steatosis) and measures liver size and structure. Ultrasound helps identify fatty liver when fat content is moderate to high, but it cannot assess inflammation or fibrosis. Therefore, results are interpreted along with blood tests and clinical risk factors for accurate diagnosis and staging.

  • Computerised tomography (CT) scan and Magnetic resonance imaging (MRI): CT scan and MRI are advanced imaging tests used in the evaluation of suspected NAFLD and NASH. These scans can help in detecting and quantifying fat in the liver more precisely than ultrasound and help in assessing liver size and structure. MRI is more sensitive for measuring liver fat and may also evaluate fibrosis. However, these tests alone cannot confirm NASH, and results are interpreted along with blood tests and clinical findings for accurate diagnosis and staging.

  • Transient elastography (Fibro scan): Transient elastography (FibroScan) is a non-invasive test recommended to assess liver stiffness and fat content in patients with suspected NAFLD or NASH. It uses painless sound-wave technology to estimate the degree of fibrosis (scarring) and steatosis without a biopsy. The test is safe, quick, and done as an outpatient procedure. It does not diagnose fatty liver alone, but it helps identify advanced fibrosis and monitor disease progression, guiding further management.

For the NASH confirmation test

  • Liver biopsy: Liver biopsy is the accurate test for confirming NASH and rarely assessing the severity of liver damage in patients with NAFLD. A small sample of liver tissue is taken in this procedure using a fine needle (usually under local anaesthesia) and examined under a microscope to look for fat deposition, inflammation, and fibrosis (scarring). It helps doctors distinguish simple fatty liver from NASH and determine the stage of the disease. Because it is an invasive procedure with small risks (such as pain or bleeding), it is usually recommended only when non-invasive tests are unclear or when advanced disease is suspected.

✅NAFLD Stages

NAFLD progresses gradually from simple fat accumulation in the liver to inflammation, fibrosis, and, in some cases, advanced liver damage. This framework helps doctors in assessing disease severity and guiding treatment strategies. The following are the four stages of NAFLD:

  • Simple Steatosis (Non-alcoholic Fatty Liver (NAFL))
  • Non-alcoholic Steatohepatitis (NASH)
  • Fibrosis
  • Cirrhosis

  • Simple Steatosis (Non-alcoholic Fatty Liver (NAFL): This is the first simple stage where fat builds up in liver cells without causing major damage. Most people do not have symptoms and may not know they have it. Liver function is usually preserved, and the risk of complications is low at this stage. This condition can be reversed with a healthy diet, exercise and weight loss. Regular monitoring helps prevent progression.

  • Non-alcoholic Steatohepatitis (NASH): This stage is characterised by fat accumulation, liver inflammation, and damage to the liver cells. NASH is therefore a more severe and advanced type of fatty liver disease. Symptoms like fatigue or mild discomfort in the abdomen may appear in some patients. It can lead to liver scarring if left untreated. Early medical attention and lifestyle modifications can help avoid or reduce damage.

  • Fibrosis: When the liver develops scar tissue due to chronic inflammation, fibrosis forms. The scarring begins to interfere with the liver's normal structure and blood flow, but it still functions. Although early fibrosis may not show any symptoms, it is a sign that the disease is progressing. Fibrosis may improve to some extent if the underlying cause is treated. Continued damage, however, can lead to advanced scarring.

  • Cirrhosis: The advanced stage of cirrhosis is when healthy liver tissue is replaced by extensive scarring. The liver stiffens and loses its ability to function. Serious side effects like accumulation of fluid, internal bleeding, and liver cancer can result from this stage. Jaundice, oedema, and weakness are possible symptoms. In cases of decompensated advanced cirrhosis, liver transplantation may be required when complications cannot be managed medically.

✅Differential Diagnosis of NAFLD and NASH

Differential diagnosis is essential in the evaluation of suspected NAFLD and NASH to exclude other causes of hepatic steatosis, liver inflammation, and abnormal liver enzymes. The following are the differential diagnoses:

  • Alcohol-related liver diseases
  • Viral hepatitis (Hepatitis B, Hepatitis C)
  • Drug-induced liver injury/steatosis
  • Autoimmune liver diseases 
  • Hemochromatosis
  • Wilson’s disease
  • Alpha-1 antitrypsin deficiency
  • Celiac disease
  • Malnutrition or rapid weight loss
  • Congestive hepatopathy
  • Budd–Chiari syndrome

Alcohol-related liver diseases:  It is important to rule out alcohol-related liver disease (ALD) before confirming suspected NAFLD or NASH because it is a crucial differential diagnosis in these patients. To diagnose non-alcoholic fatty liver disease (NAFLD), there must be minimal or no alcohol intake, and no other liver disease causes. As with NAFLD/NASH, ALD can manifest as fatty liver, inflammation (steatohepatitis), and elevated liver enzymes. To differentiate ALD from non-alcohol-related fatty liver disease, a thorough history of alcohol consumption and a clinical evaluation are necessary.

Viral hepatitis (Hepatitis B, Hepatitis C): Hepatitis B and Hepatitis C infections are evaluated by screening tests such as HBsAg and anti-HCV antibody. Like NAFLD and NASH disease, viral hepatitis can result in increased liver enzymes, inflammation, and liver fibrosis. Therefore, for an accurate diagnosis and suitable treatment planning, it is crucial to identify or rule out these infections.

Drug-induced liver injury/steatosis: Certain drugs like antiarrhythmic agents, immunosuppressants and some corticosteroids can cause fat accumulation, inflammation of the liver and elevated liver enzymes, similar to fatty liver disease. Therefore, a detailed medication history is important to identify drug-related liver injury, ensuring an accurate diagnosis and appropriate management.

Autoimmune liver diseases: Autoimmune liver diseases like primary biliary cholangitis, autoimmune hepatitis and primary sclerosing cholangitis can cause elevated liver enzymes, inflammation of the liver and progressive liver damage, which may be similar to NAFLD and NASH disease. These conditions are identified using autoantibody tests, liver function tests, and imaging. Proper identification is essential to ensure accurate diagnosis and appropriate treatment.

Hemochromatosis: A genetic disorder called hemochromatosis is represented by an excess of iron accumulation in the liver, which causes cirrhosis, fibrosis, and elevated liver enzymes. Serum ferritin and transferrin saturation are required to evaluate it, and when necessary, genetic testing is performed. It may occur similarly to NAFLD and NASH. Early identification allows appropriate management to prevent liver damage.

Wilson’s disease: Wilson's disease is a genetic disorder of copper metabolism that causes copper to accumulate in the liver and other organs, resulting in elevated liver enzymes and liver damage that is similar to NAFLD and NASH. It could manifest as neurological conditions, psychiatric changes, or liver symptoms. Evaluation consists of eye examination for Kayser-Fleischer rings, 24-hour urine copper levels, serum ceruloplasmin, and genetic testing if necessary. Since copper-chelating therapy is a treatment option, early diagnosis is important.

Alpha-1 antitrypsin deficiency: Alpha-1 antitrypsin deficiency is a genetic disorder in which low levels of the alpha-1 antitrypsin protein lead to liver cell damage and accumulation of fat in the liver. It can present with fatty liver changes, increased liver enzymes and progressive fibrosis, similar to NAFLD/NASH. Diagnosis is made using serum alpha-1 antitrypsin levels and genetic testing. Early identification helps guide monitoring and appropriate management to prevent liver and lung complications.

Celiac disease: Celiac disease is an autoimmune disease that resembles fatty liver disease by affecting the liver and causing abnormal liver enzyme levels. It is triggered by gluten. Although some patients may not have any symptoms, it may be linked to weight loss, digestive issues, or nutritional deficiencies. Serologic tests (tTG-IgA and EMA antibodies) are used to establish the diagnosis, and an intestinal biopsy is performed if necessary. Since it can be treated with a strict gluten-free diet, early detection is essential.

Malnutrition or rapid weight loss: Malnutrition or rapid weight loss can cause accumulation of fat and liver inflammation, producing abnormal liver enzyme levels similar to NAFLD and NASH. This may occur in conditions like starvation, crash dieting, or after bariatric (weight loss) surgery. The liver changes are related to changes in fat metabolism and nutritional deficiency. Identifying this cause is important because liver abnormalities may improve with proper nutritional support and gradual weight stabilisation.

Congestive hepatopathy: Congestive hepatopathy is a liver condition that causes blood congestion in the liver due to chronic heart failure or impaired blood flow from the heart. This results in liver enlargement, elevated liver enzymes, and fluid retention, which is similar to fatty liver disease on tests. Clinical history, heart evaluation, and imaging findings help in the diagnosis. Managing the underlying heart condition is essential to improving liver function.

Budd–Chiari syndrome: A disorder known as Budd-Chiari syndrome occurs when the hepatic veins are blocked, which impairs the liver's ability to pump blood out. It may mimic fatty liver disease and appear as an enlarged liver, abdominal pain, ascites (fluid build-up), and abnormal liver tests. Doppler ultrasound, CT, or MRI of the liver vessels are used to confirm the diagnosis.

✅Goals of Treatment of NAFLD and NASH

The management of NAFLD and NASH aims to reduce hepatic steatosis, control metabolic risk factors, and prevent progression to advanced liver disease. The following are the goals of treatment of NAFLD and NASH:

  • To reduce hepatic fat accumulation (steatosis).
  • Resolving hepatic inflammation (steatohepatitis).
  • Preventing the progression of fibrosis and cirrhosis.
  • Achieving optimal control of metabolic risk factors (diabetes, dyslipidaemia, hypertension).
  • To reduce the risk of cardiovascular disease.
  • Preventing complications such as hepatic decompensation and hepatocellular carcinoma.
  • Improving overall survival and quality of life.

Get Medical Second Opinion for NAFLD and NASH Treatment for Better Clarification

At PACE Hospitals, we are committed to providing our patients with the best possible care, and that includes offering second medical opinions with super specialists for treatment or surgery. We recommend everyone to get an expert advance medical second opinion, before taking decision for your treatment or surgery.

NAFLD and NASH Treatment in Hyderabad, India

NAFLD and NASH Treatment

The treatment of NAFLD and NASH focuses on lifestyle modification, control of metabolic risk factors, and prevention of disease progression. There is no single curative drug, so management is mainly long-term and multidisciplinary. It includes the following:

  • Non-pharmacological treatment
  • Pharmacological treatment
  • Surgical treatment

Non-pharmacological treatment

Non-pharmacological management is the first-line and cornerstone treatment for both NAFLD and NASH, focusing on lifestyle and risk-factor modification. Below are the non- pharmacological therapies:

  • Weight reduction 
  • Healthy balanced diet 
  • Regular physical activity 
  • Avoiding alcohol consumption
  • Smoking cessation
  • Behavioural and lifestyle counselling
  • Management of obesity and metabolic syndrome
  • Adequate sleep and stress management


Weight reduction: Gradual weight loss is the most effective way to reduce liver fat. A 7-10% reduction in body weight can improve liver inflammation and may reverse early fibrosis. Rapid or crash dieting should be avoided.

Healthy balanced diet: It is advised to eat a diet high in fruits, vegetables, whole grains, lean protein, and low in processed foods, refined sugars, and saturated fats. For fatty liver disease, Mediterranean-style eating is frequently recommended.

Regular physical activity: Regular exercise helps in reducing liver fat and improving insulin sensitivity. Advised at least 150 minutes of moderate aerobic activity per week, along with resistance exercises.

Avoiding alcohol consumption: Alcohol can worsen liver injury and accelerate disease progression. Patients with NAFLD/NASH are advised to limit or completely avoid alcohol intake.

Smoking cessation: Smoking is associated with increased liver fibrosis and cardiovascular risk. Avoiding smoking improves overall health outcomes and decreases complications.

Behavioural and lifestyle counselling: Lifestyle counselling helps patients in maintaining long-term dietary and exercise habits. Behavioural support improves adherence to weight loss and lifestyle goals.

Management of obesity and metabolic syndrome: Conditions like diabetes, high cholesterol, and high blood pressure are very important to address, as these conditions increase the risk of fatty liver disease. Proper control helps prevent disease progression.

Adequate sleep and stress management: Poor sleep and chronic stress can worsen metabolic health and liver disease. Maintaining proper sleep patterns and stress-reduction practices helps overall metabolic and liver health.

Pharmacological treatment

NAFLD and NASH pharmacology treatment mainly focuses on controlling metabolic risk factors and reducing liver inflammation. There is no specific curative drug, so medications are used with lifestyle measures to prevent disease progression and complications. It includes the following:

Common Medications (Used in Both NAFLD and NASH)

  • Antidiabetic medications 
  • Lipid-lowering drugs 
  • Antihypertensive medications
  • Treatment of associated metabolic and endocrine conditions

Specific Medications (Mainly for NASH)

  • Vitamin E therapy 
  • Insulin-sensitising agents 
  • Thyroid hormone receptor-β agonists
  • GLP-1 receptor agonists

Common Medications (Used in Both NAFLD and NASH)

  • Antidiabetic medications: Antidiabetic drugs are indicated to control blood sugar levels and improve insulin sensitivity, which is a key factor in NAFLD/NASH. Better glycaemic control helps reduce liver fat and inflammation. Some of these medications may also provide additional benefits in reducing liver enzyme levels. These medications are prescribed based on individual diabetes status and metabolic profile.

  • Lipid-lowering drugs: Lipid-lowering drugs help in controlling high cholesterol and triglycerides, which are commonly associated with fatty liver disease. Statins are the drugs which are considered safe in NAFLD/NASH and help to reduce cardiovascular risk, the leading cause of mortality in these patients. They may also help improve liver enzyme levels.

  • Antihypertensive medications: Control of high blood pressure is important in patients with NAFLD/NASH to reduce cardiovascular complications. Appropriate antihypertensive therapy helps maintain optimal vascular health and supports overall metabolic control. These medications are selected based on individual patient risk factors.

  • Treatment of associated metabolic and endocrine conditions: Management of related conditions like obesity, hypothyroidism, and metabolic syndrome is essential. Treating these conditions helps decrease disease progression and improve overall liver health. A comprehensive, multidisciplinary approach is recommended for long-term management.

Specific Medications (Mainly for NASH)

Pharmacological therapy in non-alcoholic steatohepatitis (NASH) is considered in selected patients to reduce liver inflammation, fat accumulation, and fibrosis risk. The following are the therapies recommended alongside lifestyle interventions and are guided by disease severity and metabolic comorbidities:

  • Vitamin E therapy: Vitamin E is an antioxidant that helps in reducing the oxidative stress and liver cell damage associated with NASH. According to clinical guidance, it may help certain non-diabetic adults with biopsy-proven NASH with their liver steatosis and inflammation. Because of safety concerns, it is not usually advised for people who have diabetes or cirrhosis. Therapy should be used under specialist supervision with monitoring of potential risks.

  • Insulin-sensitising agents: Insulin resistance is a key cause of fat build-up and inflammation in the liver in NASH. Insulin-sensitising medicines help the body use insulin better, which improves blood sugar control and decreases the amount of fat stored in the liver. As a result, they may help bring down liver enzyme levels and reduce liver inflammation. These medicines are especially helpful in people who have type 2 diabetes, obesity, or metabolic syndrome. Treatment is chosen individually by the doctor after assessing benefits and possible side effects, and it is always combined with weight loss, a healthy diet, and regular physical activity.

  • Thyroid hormone receptor-β agonists: Thyroid hormone receptor-β agonists are newer medicines that mainly act on the liver to help burn excess fat more efficiently. By improving fat metabolism, they reduce fat build-up in the liver and can also help improve cholesterol levels in the blood. Early studies suggest these drugs may also reduce liver inflammation and slow down liver scarring. They are prescribed only for selected patients under specialist supervision and are used along with lifestyle modifications like weight loss, a healthy diet, and regular physical activity.

  • GLP-1 receptor agonists: GLP-1 receptor agonists (glucagon-like peptide-1 receptor agonists) are medications that help control blood sugar and help in weight loss by improving how the body uses insulin. By reducing excess body fat and improving metabolism, they also help decrease fat accumulation in the liver, which is important in NASH management. In people with obesity or type 2 diabetes mellitus (T2DM), these medicines may improve liver enzyme levels and overall liver health.

Surgical treatment

Surgery is not the first-line treatment for NAFLD or NASH, but it may be considered in selected patients with severe obesity or advanced liver disease. It mainly focuses on weight reduction or liver transplantation in advanced stages. They are:

  • Bariatric (weight-loss) surgery
  • Liver transplantation

  • Bariatric (weight-loss) surgery: Bariatric (weight-loss) surgery may be considered for people with NAFLD or NASH who have severe obesity and do not improve with lifestyle changes and medicines. Significant weight loss after surgery can reduce liver fat, improve inflammation, and slow disease progression. It also helps improve related conditions such as type 2 diabetes and metabolic syndrome. This treatment is offered after careful evaluation and requires long-term lifestyle changes and follow-up care.

  • Liver transplantation: Only those with advanced non-alcoholic steatohepatitis (NASH) who have developed cirrhosis or liver failure and whose liver is no longer able to function normally are eligible for liver transplantation. This procedure can increase survival and quality of life by replacing the damaged liver with a healthy donor liver. Long-term monitoring is necessary to control metabolic risk factors to prevent recurrence, and a thorough evaluation is necessary prior to transplantation. Liver transplantation is not necessary for those with simple NAFLD or early-stage disease.

✅NAFLD and NASH Prognosis

NAFLD prognosis

Most people with NAFLD without inflammation or fibrosis have a favourable long-term outcome. Many individuals remain stable for years, especially with weight control and healthy lifestyle changes. The risk of liver-related complications is low, but there is a high risk of cardiovascular disease and metabolic complications, which are the most common causes of death in NAFLD patients.

NASH prognosis

NASH has a more serious prognosis because it involves liver inflammation and damage. A proportion of patients may develop progressive fibrosis, liver failure, cirrhosis, or liver cancer (hepatocellular carcinoma) over time. The risk of progression is higher in people with diabetes, obesity, hypertension, and advanced fibrosis. Early diagnosis and management can reduce or even reverse disease progression in some cases.

NAFLD and NASH Treatment Cost in Hyderabad, India

The cost of NAFLD (Non-Alcoholic Fatty Liver Disease) and NASH (Non-Alcoholic Steatohepatitis) treatment in Hyderabad generally ranges from ₹15,000 to ₹3,50,000 per year (approx. US $180 – US $4,210).

The exact cost of treatment varies depending on the stage of liver disease (simple fatty liver vs NASH with fibrosis), severity of liver inflammation, presence of associated conditions such as obesity, diabetes, hypertension, or high cholesterol, and the type of management required. Costs may include lifestyle modification programs, medications, liver function monitoring, imaging studies, fibroscan evaluation, and specialist consultations. Hospital facilities, diagnostic technology, and availability of cashless treatment options, TPA corporate tie-ups, and insurance assistance also influence the overall cost.


Cost Breakdown According to Type of NAFLD / NASH Treatment

  • Basic Evaluation & Lifestyle Management – ₹15,000 – ₹40,000 per year (US $180 – US $480)
  • NAFLD With Regular Monitoring (LFT + Ultrasound + Consultation) – ₹25,000 – ₹80,000 per year (US $300 – US $960)
  • NASH With Medication & Fibrosis Monitoring – ₹60,000 – ₹1,50,000 per year (US $720 – US $1,805)
  • Advanced NASH With Significant Liver Fibrosis – ₹1,20,000 – ₹3,50,000 per year (US $1,445 – US $4,210)
  • Hospitalisation for Complicated NASH (If required) – ₹1,50,000 – ₹3,50,000 (US $1,805 – US $4,210)

Frequently Asked Questions (FAQs) on NAFLD and NASH

  • What are the different stages of non-alcoholic fatty liver disease?

    Non-alcoholic fatty liver disease (NAFLD) advances through four stages. It starts with simple steatosis, which is the accumulation of fat in the liver. It leads to non-alcoholic steatohepatitis (NASH), causing inflammation and liver cell injury. Prolonged damage can cause fibrosis in the liver. In advanced cases, extensive scarring results in cirrhosis, which can alter liver function and lead to serious complications.


  • Which Is the best hospital for NAFLD and NASH Treatment in Hyderabad, India?

    PACE Hospitals, Hyderabad, is a trusted centre for the diagnosis and long-term management of fatty liver disease and metabolic liver disorders, including NAFLD and NASH.


    We have highly experienced gastroenterologists, hepatologists, endocrinologists, nutrition specialists, radiologists, and internal medicine experts who follow evidence-based protocols to control liver inflammation, prevent progression to cirrhosis, and manage associated metabolic conditions.


    We provide exceptional and best services through advanced liver function testing, fibroscan technology, ultrasound imaging, metabolic assessment programs, diet counselling, and long-term follow-up clinics, PACE Hospitals ensures safe, structured, and patient-centred fatty liver management.

  • Can NAFLD lead to liver cancer?

    Yes, NAFLD can cause liver cancer (hepatocellular carcinoma), but this usually happens when the disease is very advanced, especially in people with cirrhosis caused by NASH. In the early stages of NAFLD, when there isn't much fibrosis, the risk is much lower. Long-term inflammation and scarring of the liver raise the risk of cancer. So, people with advanced fibrosis or cirrhosis need to be screened and followed up on a regular basis to find cancer early.


  • Does every patient with NAFLD develop NASH?

    No, not all patients with NAFLD develop into NASH. Most of the patients have simple fatty liver (NAFL), which usually remains stable and may improve with lifestyle changes. Few patients develop NASH, where inflammation of the liver and injury occur. Individuals with metabolic syndrome, type 2 diabetes, obesity, and unhealthy lifestyle choices are more likely to experience progression.


  • Does NAFLD affect life expectancy?

    The majority of people with early-stage NAFLD (simple fatty liver) have normal or nearly normal life expectancies, particularly when risk factors are controlled, and lifestyle modifications are made. On the other hand, the disease may decrease survival and raise the risk of major complications if it advances to cirrhosis, advanced fibrosis, or NASH. Cardiovascular disease, rather than liver failure, is frequently the primary health risk. Maintaining a normal lifespan is largely dependent on early diagnosis and long-term lifestyle management.

  • What Is the Cost of NAFLD and NASH Treatment at PACE Hospitals, Hyderabad?

    At PACE Hospitals, Hyderabad, the cost of NAFLD and NASH treatment typically ranges from ₹12,000 to ₹3,20,000 and above per year (approx. US $145 – US $3,855), making it a cost-effective option for specialised liver care compared to others. However, the final cost depends on:

    • Stage of liver disease (NAFLD vs NASH)
    • Presence of fibrosis or liver damage
    • Frequency of monitoring tests
    • Requirement for medications and metabolic control
    • Associated conditions like diabetes or obesity
    • Specialist consultations and follow-up
    • Imaging and fibroscan evaluation
    • Hospitalisation, if required

    For early-stage fatty liver disease, costs remain toward the lower end with lifestyle management and monitoring, while advanced NASH with fibrosis may fall toward the higher range.


    After a detailed liver evaluation, imaging review, and metabolic assessment, our specialists provide a personalised treatment plan and transparent cost estimate aligned with liver health goals and long-term prevention strategies.

  • Looking for the Best NAFLD and NASH Treatment Hospital Near Me?

    If you’re searching for the top fatty liver treatment hospital near me in areas like HITEC City, Madhapur, Kondapur, Gachibowli, Kukatpally, or KPHB, it is essential to choose a hospital with experienced hepatology and metabolic care specialists.

    • Effective NAFLD and NASH management requires:
    • Early liver disease detection
    • FibroScan and imaging-based fibrosis assessment
    • Metabolic risk factor management
    • Diet and lifestyle intervention programs
    • Regular liver function monitoring

    At PACE Hospitals, Hyderabad, patients receive structured, protocol-driven fatty liver care focused on preventing progression to cirrhosis or liver failure.

How is NAFLD or NASH diagnosed?

The diagnosis of NAFLD or NASH is made using medical history, physical examinations, imaging studies, and blood tests. To identify liver injury, doctors first assess risk factors like alcohol consumption, diabetes, and obesity. Then they perform liver function tests. Liver fat can be detected by imaging tests such as abdominal ultrasound, CT, or MRI, and fibrosis can be evaluated with non-invasive tests like FibroScan. To confirm NASH and assess the extent of liver damage, a liver biopsy is carried out in certain circumstances.

Can NAFLD be mistaken for other liver diseases?

Yes, NAFLD can be mistaken for other liver diseases as symptoms and liver enzyme changes are similar with the other liver diseases. Before evaluating NAFLD, diseases like viral hepatitis, autoimmune liver disease, alcohol-related liver disease, genetic/metabolic disorders, and drug-induced liver injury are carefully diagnosed. This is done using a proper medical history, physical examination, blood tests, and imaging studies. Correct diagnosis is important because the treatment and long-term management differ for each condition.

Which imaging tests are used to evaluate NAFLD and NASH?

Imaging tests are used to detect fat in the liver and assess the severity of disease in NAFLD and NASH. Abdominal ultrasound is the most common first-line test to identify fatty liver. More imaging, like a CT scan or an MRI, can quantify liver fat and evaluate complications. Transient elastography (FibroScan) is used to assess liver stiffness and fibrosis. These non-invasive tests help diagnose and monitor without the need for a liver biopsy in many cases.

Can LFT confirm NAFLD?

No, Liver function tests (LFTs) alone cannot confirm the NAFLD. A slight increase in liver enzymes like ALT (alanine aminotransferase) and AST (aspartate aminotransferase), which can indicate liver injury but are not specific to fatty liver disease. ALT and AST levels may even be normal in some NAFLD patients. Therefore, diagnosis requires imaging tests (such as ultrasound or FibroScan) and exclusion of other liver diseases.

Is ultrasound better than FibroScan for non-alcoholic fatty liver?

Ultrasound and FibroScan are different but similar uses in NAFLD. Ultrasound is usually the first-line, widely accessible test to detect fat in the liver, but it cannot reliably measure fibrosis or distinguish NASH. Transient elastography, or FibroScan, measures liver stiffness and fat content, which helps assess the severity of fibrosis and track the progression of the disease. Therefore, neither is "better" than the other; FibroScan is better for staging fibrosis and follow-up, while ultrasound is best for initial detection.

Is vitamin therapy useful in NAFLD/NASH?

Vitamin therapy, particularly vitamin E, may be useful for certain patients with NASH to reduce liver inflammation and damage. But it is not usually suggested for all NAFLD patients; instead, it is mostly used for non-diabetic adults with confirmed NASH under the care of a specialist. It depends on the person's risk and side effects. Vitamin therapy should always be combined with lifestyle changes like weight loss, a healthy diet, and regular exercise, which remain the primary treatment.

Can NASH be treated with medicines?

NASH cannot be cured by a single medication. However, to reduce liver inflammation, improve insulin resistance, and promote weight loss, doctors may prescribe specific drugs to a limited number of patients. These medicines are selected based on the patient's overall health, including the presence of diabetes or obesity. Treatment is always individualised and supervised by a specialist. Along with medicines, weight loss, a healthy diet, and regular exercise remain the most important parts of treatment.

What type of diet is recommended for NAFLD/NASH?

A balanced, calorie-controlled diet is recommended to encourage gradual weight loss and reduce liver fat. Advised people to consume more fruits, vegetables, whole grains, lean meat, and healthy fats (like unsaturated fats) while consuming less added sugars, refined carbohydrates, sugary drinks, and saturated fats. A Mediterranean-style diet is usually suggested for its metabolic benefits. Portion control and long-term healthy eating habits are essential for improving liver health and preventing disease progression.

Is bariatric surgery helpful in NAFLD?

Yes, bariatric (weight-loss) surgery is helpful in people with NAFLD or NASH who have severe obesity and do not improve with lifestyle changes and medications. Weight loss after surgery can reduce liver fat, reduce inflammation, and may reverse early fibrosis. It also helps in controlling diabetes and metabolic syndrome, which contribute to fatty liver disease. This surgery is offered after careful evaluation and requires long-term follow-up and lifestyle changes.

What is the role of liver biopsy in NAFLD?

The most accurate test to determine the level of inflammation and fibrosis in NAFLD and to confirm NASH is a liver biopsy. It directs treatment choices and helps in differentiating between simple fatty liver and other severe conditions. However, due to its invasive nature, it is only utilised in selected patients when staging is necessary or the diagnosis is unclear. Non-invasive tests are often used first, and biopsy is reserved for specific clinical situations.

Is NAFLD and NASH Treatment Covered by Insurance at PACE Hospitals?

Yes, NAFLD and NASH treatment is generally covered under most health insurance policies at PACE Hospitals, subject to policy terms and approval. While outpatient consultations and routine monitoring may depend on policy benefits, hospitalisation for complications or advanced liver disease is typically covered under private and corporate health plans.

At PACE Hospitals, patients can benefit from:

  • Cashless hospitalization facilities with empaneled insurance providers
  • Assistance from a dedicated insurance and TPA coordination team
  • Pre-authorization support and documentation guidance
  • Transparent cost estimates before admission
  • Support for government health schemes where applicable

Coverage depends on waiting periods, outpatient coverage clauses, sum insured limits, and policy inclusions. Patients are encouraged to share insurance details in advance so the hospital’s insurance desk can verify eligibility and streamline approvals.