Hepatology is an area of medicine that focuses on diseases of the liver as well as related conditions.
A hepatologist is a specialized doctor involved in the diagnosis and treatment of hepatic diseases, which include issues that affect your:
Here’s what you need to know if you’re considering seeing a hepatologist for diagnosis or management of a related medical condition and are seeking to obtain a referral to this type of specialist.
Hepatology is distinct from other specialized forms of medicine because of its focus on organs affected by hepatic diseases. Your hepatic system includes the following organs.
Hepatology’s primary focus is on the liver.
This can also happen when the digestive enzymes made by the liver or pancreas can’t be released due to a blockage by a stone
The gallbladder is a small organ located on the upper-right part of your stomach.
The gallbladder is a pouch that collects the bile produced by the liver. When you eat a meal, it contracts and dumps its contents into the intestines to help with digestion.
Gallstones can form when bile imbalances occur, thereby blocking bile flow.
Also called the biliary tree or biliary system, the biliary tract is the connection, or tract, between the liver, the gallbladder, and the pancreas.
The biliary tract allows bile and pancreatic enzymes to get into the small intestine to help with digestion, including fat digestion.
Hepatologists are doctors who specialize in the field of hepatic diseases and the organs that these conditions affect. Their goal is to help diagnose and treat hepatic conditions, such as hepatitis, fatty liver disease, pancreatitis, and more.
While hepatology is not a board certified specialty according to the American Board of Medical Specialties (ABMS), it’s generally considered a subspecialty of gastroenterology. It’s only been more recently regarded as separate from gastroenterology in the last few decades.
As such, doctors who are trained in hepatology are also certified in both internal medicine and gastroenterology first.
Hepatologists primarily treat liver diseases, including:
- hepatitis infections
- fatty liver disease, both alcohol-related and not
- metabolic liver diseases
- liver cancer
Additionally, a hepatologist may help treat other conditions that impact the hepatic system, such as:
- pancreatic cancer
- gallbladder cancer
- gallbladder inflammation (cholecystitis)
- bile duct stones (choledocholithiasis)
- bile duct adenomas (noncancerous tumors)
- bile duct cancer
Some hepatologists may be able to diagnose cancer, but they’ll most likely make a referral to an oncologist for further treatment of cancer.
Hepatologists perform a wide range of procedures that help diagnose or treat conditions that affect your hepatic system.
Procedures performed by hepatologists
- blood testing to detect signs of infections, such as gallstones and pancreatitis, and inflammation of hepatic organs
- imaging tests, such as ultrasounds, to identify gallstones, cysts, and tumors
- cholescintigraphy scans that use small amounts of radioactive material to help take pictures of the biliary tract
- endoscopies performed via long tubes with cameras to help provide images of your hepatic system to get a better look at your gallbladder and bile ducts
- hepatobiliary iminodiacetic acid (HIDA) scans to monitor bile production
- biopsies of cysts, tumors, or other suspicious growths on your hepatic organs
It’s important to meet with your doctor right away if you have the following possible signs of a hepatic condition:
- persistent abdominal pain
- abdominal swelling
- chronic fatigue
- loss of appetite
- unintentional weight loss
- dark or bloody urine
- bloody, pale, or dark stools
- chronic diarrhea
- yellowing of the skin or eyes (jaundice)
- increased heart rate
- low-grade fever, with or without chills
- leg or ankle swelling
Typically, you’ll need a referral from your primary care doctor in order to see a hepatologist. Results from a physical exam and blood testing can warrant a referral to a hepatologist.
Your doctor may refer you based on some of the symptoms you’re experiencing as well as your medical history or individual risk factors for hepatic conditions.
You may need to see a hepatologist for these symptoms if you have a personal or family history of hepatic conditions. For example, you may be at an increased risk of pancreatitis if you’ve previously had gallstones.
Your doctor may recommend regular screenings if you’re over age 50 or if you:
Hepatology is linked to gastroenterology because it involves parts of the gastrointestinal (GI) tract.
Like the hepatic system, the GI tract includes the liver, pancreas, and gallbladder. It also includes the:
Hepatology is sometimes considered a branch of gastroenterology because both specialties encompass some of the same organs. A gastroenterologist can help diagnose and treat similar conditions, but a hepatologist’s focus is narrower.
Based on your current symptoms and overall health history, your primary care doctor can help you decide whether you can benefit more from a general gastroenterologist or a hepatologist.
It’s also possible to see an internal medicine doctor who specializes in these diseases.
If you believe you need to talk with a hepatologist, see your primary care doctor for a referral.
During this time, it can help to keep a journal of your symptoms to give both your doctor and specialists better insight into your condition.
Once you undergo care from a hepatologist, your specialist will work closely with your primary care doctor to help with disease management.
If you suspect you have any symptoms or risk factors for a hepatic condition, talk with your primary care doctor for a referral to a hepatologist.
Diseases of the hepatic system are also increasing in prevalence, which makes the field of hepatology an even more crucial specialty to many experiencing hepatic conditions.
The sooner you seek diagnosis and treatment, the better your outcome can be.