Though there may be no noticeable symptoms of NASH, you may notice pain in the upper right abdominal area (where the liver is) or experience fatigue. Typically, the first sign of liver disease, like NASH, is when cirrhosis (scarring of the liver) occurs. Cirrhosis may cause certain symptoms you can watch for, including: Itching of the skin Yellowing of the eyes and skin Swelling in the abdominal area