Hepatologist

Hepatologist is not a word as familiar as, for example, pediatrician, cardiologist or dentist, and therefore, it often raises a lot of questions. Who is a hepatologist?

This is a very important and necessary specialist who deals with problems of the liver and bile ducts. As a rule, a patient rarely consults a hepatologist on his own: patients are often referred to this doctor by a therapist or gastroenterologist.

The liver is a very specific organ that requires a truly specialized specialist. Often, a gastroenterologist cannot make an accurate diagnosis, since the diagnosis of liver diseases can be complicated by diseases of other abdominal organs. A hepatologist will question the patient, conduct an examination and send him for the necessary tests.

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When should you see a hepatologist?

It is worth contacting a hepatologist when the patient has specific "liver" symptoms. Namely: weight loss associated with lack of appetite, yellowing of the skin, dark circles under the eyes, itchy skin, change in the color of feces to light brown, and change in the color of urine to brown, pain in the liver.

It is worth noting that if the patient paid attention in time and responded correctly to the symptoms noticed (contacted a doctor), then in most cases a positive outcome of the disease is likely. Specific male symptoms that may indicate liver problems are decreased sexual function, abdominal growth (the belly becomes like a "beer belly") and enlarged mammary glands of the female type. Patients with liver cirrhosis experience swelling and bleeding gums, constant aching pain in the peritoneum, and some absent-mindedness, inability to concentrate on work or other long-term activities due to an incessant feeling of general fatigue.

Often, in the early stages of liver disease, patients simply do not pay attention to the above symptoms, but, nevertheless, if a state of fatigue haunts you for a week or more, your stomach hurts, and your skin has become yellow like an Indian - you urgently need to visit a hepatologist.

What diagnostic methods does a hepatologist use?

A hepatologist always prescribes an ultrasound examination of the liver, which will show the general condition of this vital organ, namely: whether the liver is enlarged, whether the structure of its tissues has changed and whether there are any neoplasms. If there is a suspicion of changes in the structure of the tissues, the hepatologist sends his patient to an MRI of the abdominal organs. This diagnostic procedure will show the general condition of the abdominal organs and the interaction of the liver with them. A specific "liver" analysis prescribed by a hepatologist is esophagoscopy (examination of the esophagus using a special tube) and colonoscopy (examination of the rectum using a colonoscope). All of the above diagnostics will help determine the health of the body as a whole, and the condition of the liver in this body.

Today, "advanced" patients know that they should not go to the doctor without the results of basic tests. So, what tests should be taken when visiting a hepatologist?

To diagnose liver diseases, it is necessary to take a specific blood test, the so-called "liver profile". This test is a blood biochemistry test that will show the level of bilirubin (which increases with jaundice - a violation of the outflow of bile), the level of aspartate aminotransferase (the main enzyme produced by liver cells, the increase of which is directly associated with inflammatory processes in the organ), the level of alanine aminotransferase (a liver enzyme, the level of which increases with cirrhosis of the liver), the presence of C-reactive protein (appears during tissue decomposition, may indicate cirrhosis), as well as the level of gamma-glutamyl transferase (an enzyme produced by the liver, which significantly increases in the blood at the level of constant and long-term alcohol intake). The blood biochemistry test is taken in the morning on an empty stomach. A couple of hours before the test, you cannot smoke, drink juice, tea or coffee, or chew gum. It probably goes without saying that you should refrain from drinking alcohol for 3 days before taking the test, and also avoid stress and heavy physical exertion.

What does a hepatologist do?

What diseases does a hepatologist treat? This specialist deals with liver problems and neutralizing the impact of its pathologies on the body as a whole. A hepatologist is competent to diagnose and treat such liver and bile duct diseases as: hepatitis (acute and chronic), cirrhosis, toxoplasmosis (transmitted by rodents), enterovirus hepatitis, infectious mononucleosis (Epstein-Barr disease), leptospirosis (Weil-Vasiliev disease), jaundice, reactive hepatitis, alcoholic hepatitis, hepatitis B and C. Thus, a hepatologist, although a narrow-profile specialist, is still a broad-spectrum doctor, capable of not only treating liver and bile duct diseases, but also correcting the state of the immune system.

Advice from a hepatologist

To prevent hepatitis B and C, do not drink raw tap water or eat unwashed vegetables and fruits. Always remember to wash your hands before eating and after using the toilet. Do not have sex without a condom if one of the partners has hepatitis B or C, or have anal sex or sex during menstruation. If your work involves blood (for example, you are a surgeon, dentist, or medical lab technician), do not forget to wear protective glasses before starting work, since infected blood, when it gets on the mucous membrane of the eye, instantly transmits the hepatitis virus.

If the patient suffers from cirrhosis, he/she should monitor the regularity of bowel movements, which should be 2 times a day. It is also recommended to monitor the amount of liquid consumed and excreted (if you drink less than you "excrete", you need to sound the alarm and urgently consult a doctor). General prevention of liver and bile duct diseases is a diet with a reduced content of spicy, fried and fatty foods, as well as moderate alcohol consumption (or its complete absence in your diet: an exception can be good red wine, at the rate of one glass once a week). Take care of your liver and be healthy!