What Is a Hepatologist?

Hepatologists are medical doctors who diagnose, treat, and manage problems associated with your liver, gallbladder, bile ducts, and pancreas.

Liver problems are a growing issue around the world, with conditions like cirrhosis, fatty liver disease, and hepatitis affecting the lives of millions of people each year.

In the U.S. alone, 1.8% of all adults live with some type of diagnosed liver disease. These health trends show the importance of medical professionals like hepatologists who can help to treat and manage liver conditions and reduce the risk of further liver damage.

What Does a Hepatologist Do?

Hepatologists most often see people who have health conditions related to the liver. Some of the most common health issues they treat include alcohol-related liver disease, hepatitis, and liver cancer.

Hepatologists work to identify which hepatic organ is most affected and to which degree, so they can diagnose the condition and identify the best treatment for it. 

Once a branch of gastroenterology, hepatology has developed into its medical field with its subspecialties.

Education and Training

Hepatologists go through medical school and complete advanced training with certifications.

This process involves completing:

  • Four years in medical school to earn a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO)
  • A three-year residency in internal medicine
  • A certification exam from the American Board of Internal Medicine to be board certified in gastroenterology
  • A three-year fellowship in gastroenterology and one-year advanced fellowship in transplant hepatology; or a three-year joint fellowship in gastroenterology and transplant hepatology
  • A certification exam from the American Board of Internal Medicine for transplant hepatology 

What Conditions Does a Hepatologist Treat?

Hepatologists treat many conditions, including:

  • Alpha-1 Antitrypsin Deficiency
  • Alcoholic Hepatitis
  • Ascites
  • Cirrhosis
  • Hepatitis
  • Hepatic Encephalopathy
  • Liver Cancer
  • Nonalcoholic Fatty Liver Disease (NAFLD)
  • Nonalcoholic Steatohepatitis (NASH)
  • Obesity
  • Primary Biliary Cholangitis
  • Primary Sclerosing Cholangitis

Reasons to See a Hepatologist

Your doctor is typically the healthcare professional who will refer you to a hepatologist. They might refer you to this specialist based on their assessment of some concerning symptoms or signs, including the following: 

You Have a Liver Condition

These might include cirrhosis, hepatitis, nonalcoholic fatty liver disease (NAFL), nonalcoholic steatohepatitis (NASH), primary biliary cholangitis, and primary sclerosing cholangitis.

You Have Abnormal Liver Function Test Results

Liver function blood tests check for how your liver enzymes and proteins are working. If your blood tests show results that are too high or too low, it can indicate problems with your liver, such as hepatitis, cirrhosis, or medication overdoses. 

You Have a Symptom of Liver Problems

These may include:

Sudden gastrointestinal bleeding. Sudden bleeding from your upper GI tract could mean you have a hemorrhage from liver cirrhosis. Cirrhosis scarring on the liver, which can happen due to hepatitis or chronic heavy drinking, can lead to lesions and abnormal veins in your esophagus and stomach. These lesions can rupture and cause bleeding or vomiting of blood.

Jaundice is when your skin and whites of the eyes take on a yellowish tone. This yellow color comes from the accumulation of bilirubin, a type of bile pigment that forms from the breakdown of hemoglobin.

When bilirubin builds up, it means that your liver isn’t working like it should move bilirubin into the digestive tract. 

You might develop jaundice from hepatitis, bile duct blockage, acetaminophen overdose, auto-immune diseases, or toxin poisoning, all of which can lead to liver damage or even liver failure.

Deep yellow or brown-colored urine can accompany jaundice of the skin and eyes. Dark yellow or brown urine could be a sign that your liver and kidneys aren’t working properly, or that you have developed a urinary tract infection. It might also be a reaction to certain medications that your liver is having trouble breaking down.

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