A liver doctor, or hepatologist, is a liver specialist who treats diseases and disorders relating to the liver, pancreas, gallbladder and biliary system. A hepatologist is a medical doctor who has chosen to specialize in hepatology – the study and treatment of liver conditions. The hepatologist will examine and assess patients at risk of liver problems, or who have been referred by a general doctor with suspected liver trouble. The liver plays many vital roles in maintaining a healthy body: it helps convert food into energy that the body can use; acts as a cleansing filtration system; helps the body fight infections, and more.
Liver doctors can use many tests to help to assess and diagnose problems, including blood tests for liver function and other markers for disease, as well as magnetic resonance imagining (MRI) and ultrasound scans. It may also be necessary to perform a biopsy, where a tiny piece of tissue is taken. These can be performed percutaneously or through the skin on the abdomen. Local anaesthetic injections are given, then a tiny incision is made and a needle used to take a small sample. Some medications may need to be avoided for some time before the procedure; this will be fully explained well in advance.
A liver disease specialist sees patients with a range of problems. Liver disease is often closely associated with a history of excessive alcohol consumption, but there are many other reasons a person may suffer from problems relating to the liver.
A liver specialist is likely to mainly work in a hospital setting, with liver clinics for long-term patients. They work with a team of associated professionals including dietitians, alcohol specialist nurses, and liver or gastrointestinal surgeons.
A fatty liver disease is one of the more common diseases of the liver and is associated with obesity and related diseases like type 2 diabetes, high blood pressure and high cholesterol.
A liver doctor also looks after people with lesions and tumours of the liver, which can be benign (not cancerous) or malignant (cancerous). Liver cancer treatment can include chemotherapy, radiotherapy, or liver surgery.
As some liver diseases can be prevented or reduced by changes in diet and lifestyle, educating people on how to keep their liver healthy is an important part of a hepatologist’s work. There are many commercially available ‘liver cleanse’ products and diets, but these can be of varying quality. If you are considering following any kind of liver cleansing regime, consulting a hepatologist and specialist dietitian is the best way to ensure that the plan you follow is safe, effective, and based on the best available medical evidence.
In some extreme cases of liver damage or liver failure, the only long-term option is to undergo a liver transplant. People who need a liver transplant may have to wait for some time for a liver to become available, and while they’re waiting will need to be closely monitored by a hepatologist. Once they’ve had a transplant they will need to take life-long medication to stop their body from rejecting the new liver, and must continue to be monitored by specialists.