Although there may be no noticeable symptoms of NASH, you could have fatigue or pain in the upper right side of your abdomen (where the liver is). In general, the initial sign of liver disease, such as NASH, is when cirrhosis occurs (scarring of the liver). There are certain symptoms of cirrhosis that you can watch for, including: Itching of the skin Swelling in the abdominal area Yellowish appearance to the eyes and skin