A hepatologist is a specialist in the branch of medicine called Hepatology, which includes the study of body parts such as the liver, the biliary tree, the gallbladder and the pancreas. A hepatologist manages disorders in these areas. Hepatology was traditionally a subspecialty of gastroenterology, but recent advances in the understanding of this subspecialty have made it a field of its own.
Hepatologists deal most frequently with viral hepatitis and diseases related to alcohol. Hepatitis impacts millions of people worldwide and has been associated with a number of poor outcomes such as liver cancer and liver transplantation. Particularly, hepatitis B and hepatitis C frequently cause liver cancers. Alcohol consumption has been associated with cirrhosis and other complications.
A general practitioner may refer a patient to a hepatologist for a variety of reasons including drug overdose, gastrointestinal bleeding from portal hypertension, jaundice, ascites, enzyme defects or blood tests that indicate liver disease. Evidence of diseases in the biliary tree, fever indicating tropical diseases such as hydatid cyst, kala-azar or schistosomiasis may also cause a general practitioner to refer a patient to a hepatologist. These specialists also may treat hemochromatosis or pancreatitis or conduct follow-up among patients who have received a liver transplantation.
Some of the procedures performed by hepatologists include endoscopic retrograde cholangiopancreatography (ERCP), transhepatic pancreato-cholangiography (TPC) or transjugular intrahepatic portosystemic shunt (TIPSS).
Hepatologists can treat adult or pediatric patients.
To become a hepatologist, an individual must complete undergraduate study, receive a Doctor of Medicine (MD) or a Doctor of Osteopathic Medicine (DO) degree, and then complete a 3-year residency in gastroenterology followed by a fellowship of 2 or 3 years in that field. These candidates then should receive certification in gastroenterology by the American Board of Internal Medicine.
Once these gastroenterologists are certified, they should devote the majority of their time to the liver and its associated complications.