The doctor who specializes in treating diseases and conditions of the liver is called a hepatologist. Hepatology is a branch of medicine that deals specifically with diagnosing and managing liver disorders.
The liver is a vital organ that has many essential functions in the body. It processes nutrients, filters toxins from the blood, fights infections, and produces bile among other important jobs. Like any other organ, the liver can develop various diseases and conditions that need specialized medical care.
When the liver is diseased or injured, it can lead to serious complications. Some common disorders that affect the liver include hepatitis, cirrhosis, fatty liver disease, liver cysts, and liver cancer. That’s why having a dedicated doctor to treat the liver is crucial.
Hepatologists are trained to prevent, diagnose, and manage acute and chronic liver diseases. They have expertise in interpreting diagnostic tests, providing medications, overseeing imaging procedures, and determining if liver transplantation is required for end-stage liver failure.
What is Hepatology?
Hepatology is the branch of medicine concerned with the structure, function, diseases, and disorders of the liver. The term is derived from the Greek word “hepar” meaning liver.
Some of the main areas that hepatologists study and treat include:
- Viral hepatitis – Hepatitis A, B, C, D, E
- Alcoholic liver disease
- Non-alcoholic fatty liver disease (NAFLD)
- Genetic and autoimmune liver diseases
- Cirrhosis
- Liver cancer
- Gallbladder and biliary tract disease
- Vascular disorders of the liver
- Liver injuries and trauma
- Liver transplantation
In addition to managing acute and chronic liver illness, hepatologists carry out preventive medicine to reduce the incidence of liver disease. This includes vaccination programs, community education, and policy changes related to alcohol, drug use, and metabolic disorders that impact the liver.
When to See a Hepatologist
You may need to visit a hepatologist if you have symptoms or have been diagnosed with conditions such as:
- Jaundice (yellowing skin and eyes)
- Chronic hepatitis B or hepatitis C infection
- Cirrhosis
- Gallstones
- Fatty liver
- Abdominal swelling or fluid retention
- Nausea, vomiting, and abdominal pain
- Unexplained itching
- Chronic fatigue
- Abnormal liver function blood tests
A hepatologist can run specialized tests to determine if you have a liver problem. They may order blood tests, liver enzyme tests, viral hepatitis serology, autoantibody tests, abdominal ultrasound, CT or MRI scans, and liver biopsy if needed.
Based on the test results, the hepatologist will diagnose the specific liver condition and advise on the best treatment options. This may include medications, dietary changes, surgery, or plans for a liver transplant.
Types of Hepatologists
There are several subspecialties of hepatology focused on specific liver diseases and patient groups:
Pediatric Hepatology
These hepatologists have additional training to treat liver diseases in infants, children, and adolescents. Some pediatric liver conditions include biliary atresia, alpha-1-antitrypsin deficiency, autoimmune hepatitis, and hepatitis A, B or C.
Transplant Hepatology
Transplant hepatologists care for patients who require a liver transplantation. They evaluate patients for transplant eligibility, perform pre-transplant care, oversee the transplant surgery, and provide post-transplant follow-up.
Surgical Hepatology
Hepatologists trained in liver surgery provide operative management of diseases such as hepatic cancer and cysts. They perform procedures like tumor resection, laparoscopy, and liver transplantation.
Diagnostic Hepatology
These hepatologists interpret results from liver function tests, liver biopsies, and advanced imaging studies. They provide expertise on the clinical meaning of complex test findings.
Training and Certification
Hepatologists first complete medical school and obtain a medical degree. After this, they undergo a three-year internal medicine residency program.
To subspecialize in hepatology, physicians then complete a two to three-year fellowship training program in the field. This advanced training focuses on the diagnosis and management of liver disorders through supervised clinical experiences.
After finishing their residency and fellowship, hepatologists can become certified in the subspecialty by passing board exams from the American Board of Internal Medicine (ABIM) or the American Osteopathic Board of Internal Medicine (AOBIM).
Hepatologists must renew their board certification every ten years through continuing education, re-examination, or simulation-based assessment.
Where Do Hepatologists Work?
Hepatologists work in healthcare settings such as:
- Hospitals – Inpatient wards and outpatient liver clinics
- Academic medical centers – As professors, researchers, and clinical care
- Private practice physician offices
- Public health clinics
- Transplant centers
They collaborate closely with other specialists to provide well-rounded care to patients with liver disease. This may include gastroenterologists, radiologists, oncologists, surgeons, primary care doctors, and infectious disease specialists.
Procedures Performed by Hepatologists
Some of the diagnostic and treatment procedures hepatologists are trained to perform include:
- Paracentesis – Removing abdominal fluid with a needle for analysis
- Liver biopsy – Using a needle to extract a small liver tissue sample for examination under a microscope
- Endoscopic retrograde cholangiopancreatography (ERCP) – Using an endoscope and X-rays to view the bile ducts and pancreatic duct. Can also take tissue samples or remove bile duct blockages.
- Transjugular intrahepatic portosystemic shunt (TIPS) – Inserting a stent via the jugular vein to connect the portal and hepatic veins to lower blood pressure in the portal vein and treat complications of cirrhosis
- Radiofrequency and alcohol ablation – Destroying liver cancer tumors by applying heat or alcohol injection
- Biliary stent placement – Inserting stents by endoscope or catheter to open blocked bile ducts
Hepatologists have expertise in selecting appropriate candidates for invasive procedures and properly executing them for diagnosis and treatment.
Role in Medical Research
Academic hepatologists significantly contribute to advancing medical knowledge on liver disease through research. Their important research activities include:
- Conducting clinical trials for new hepatitis medications, therapies for cirrhosis complications, and surgical techniques
- Publishing findings from population studies and clinical data registries on risk factors and outcomes for liver disorders
- Studying the molecular mechanisms of liver cancers to develop targeted therapies
- Identifying genetic markers associated with increased liver disease susceptibility
- Investigating the pathogenesis of non-alcoholic fatty liver disease and steatohepatitis
- Evaluating safety and efficacy of new imaging techniques for diagnosing liver lesions
Hepatology research aims to enhance our understanding of liver health and disease leading to improved treatments and preventive strategies.
Importance of Hepatologists
Hepatologists play a crucial role in healthcare by:
- Providing prompt, accurate diagnosis of acute and chronic liver disorders based on patient history, exam findings, and specialized tests
- Developing integrated treatment plans for liver disease using medications, dietary changes, surgery, or transplant referrals
- Monitoring patients closely for complications of liver conditions
- Coordinating multidisciplinary care teams for optimal management of complex liver disorders
- Improving understanding of liver health through clinical and translational research
- Educating the public and policymakers about preventing liver injury and diseases
- Filling a shortage of physicians dedicated to hepatology as rates of fatty liver disease and hepatitis continue to increase
With their extensive knowledge and skill set, hepatologists provide high-value services to patients at risk for and suffering from liver disease.
Conclusion
Hepatologists are physicians who specialize in diseases of the liver, a vital organ with many essential functions. Also known as liver specialists, they have training and expertise to prevent, diagnose, treat, and manage acute and chronic liver conditions.
Hepatology requires advanced study of the liver’s complex biology and disorders that can afflict it. These physicians play a key role in providing specialized care to patients across the spectrum of liver disease. Their services help optimize outcomes and reduce liver-related morbidity and mortality.
As rates of fatty liver disease, viral hepatitis, and liver cancer rise, hepatologists will continue to be highly valued members of healthcare teams. Their specialized knowledge makes them the go-to experts for optimizing liver health.