liver disease

In my experience, two of the most challenging underwriting topics for advisors to understand are liver disease and kidney disease. 
 

Nonalcoholic steatohepatitis (NASH) is a more aggressive form of liver disease. It is inflammatory in nature, is much quicker in disease progression than the standard type and may result in liver cirrhosis and failure. Both in clinical practice and in underwriting, NASH is under-recognized in its incidence. It actually affects up to five percent of the United States population and its prevalence is on the rise.

Liver fibrosis is the replacement of functioning hepatic tissue with fibrous tissue. Alcohol overuse, hepatitis of any kind, and nonalcoholic steatohepatitis (NASH) often leave behind damage with not only an active process but one where compromise may persist long after the cause has been controlled or eradicated. Knowing how to assess liver fibrosis in the aftermath of these conditions is an important part of underwriting liver disease.

Liver diseases can range from mild fatty liver disease to complete decompensation and loss of liver function,  Some are acquired by virus, some due to diet and alcohol use, some secondary from other body illnesses, and some are primary arising directly in the liver and bile ducts.  Two such primary diseases of a very serious nature are primary sclerosing cholangitis and primary biliary cirrhosis.