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Hepatologist

Last reviewed by: Aleksey Portnov , medical expert, on 01.06.2018

The hepatologist is not as familiar as a pediatrician, cardiologist or dentist, and therefore often causes a lot of questions. Who is a hepatologist?

This is a very important and necessary specialist dealing with liver and bile duct problems. As a rule, the patient seldom addresses to the hepatologist independently: to this doctor of patients the therapist or the gastroenterologist often sends.

The liver is a very specific organ, requiring a really narrowly specialized specialist. Often, a gastroenterologist can not make an accurate diagnosis, since the diagnosis of liver diseases can be difficult with diseases of other abdominal organs. Hepatologist same, ask the patient, will inspect and send for the necessary tests.

When should I contact a hepatologist?

The hepatologist should be treated when the patient has specific "liver" symptoms. Namely: weight loss, coupled with lack of appetite, icterus of the skin, dark circles under the eyes, itchy skin, discoloration of the feces to light brown, and a change in the color of urine to brown, pain in the liver.

It is worth noting that if the patient has paid attention in time and correctly responded to the noticed symptoms (turned to the doctor), in most cases a positive outcome of the disease course is probable. Specific male symptoms, possibly indicating a problem with the liver, are a reduction in sexual function, abdominal growth (the belly becomes like a "beer") and an increase in mammary glands by the female type. In patients with cirrhosis of the liver there is swelling and bleeding of the gums, there are persistent aching pains in the peritoneum, as well as some absentmindedness, inability to concentrate attention on work or other lengthy occupations in connection with the continuing 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 the fatigue state pursues you for a week or more, the stomach hurts, and the skin becomes yellow like an Indian - you are urgently shown a visit to doctor-hepatologist.

What diagnostic methods does the hepatologist use?

The hepatologist always appoints 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 or whether there are new growths. If a change in tissue structure is suspected, the hepatologist sends his patient to the MRI of the abdominal cavity. This diagnostic procedure will show the general condition of the abdominal organs and the interaction of the liver with them. A specific "hepatic" analysis, appointed by a hepatologist, is esophagoscopy (examination of the esophagus by means of a special tube) and colonoscopy (examination of the rectum with a colonoscope). All of the above diagnoses can help determine the health of the body as a whole, and the liver in this body.

Today, "advanced" patients know that you should not go to the doctor without the results of the basic tests. So, what tests do you need to pass to the hepatologist?

To diagnose liver diseases, it is necessary to pass a specific analysis of the blood, the so-called "liver profile." This analysis is a blood test for biochemistry, which 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 the liver cells, the increase of which is directly related to the inflammatory processes in the organ), the level of alanine aminotransferase (liver enzyme , the level of which increases with cirrhosis), the presence of C-reactive protein (appears in the decomposition of tissues, may indicate cirrhosis), as well as the level of gamma-glutamyltra nsferase (an enzyme produced by the liver, which significantly increases in the blood at the level of constant and prolonged intake of alcohol). The blood test for biochemistry is given in the morning on an empty stomach. For a couple of hours before the test, you can not smoke, drink juice, tea or coffee, and chew gum. It is not necessary, probably, to mention that 3 days before the test is done, it is necessary to refrain from taking alcohol, and also to exclude stresses and great physical exertion.

What does the hepatologist do?

What diseases does the hepatologist treat? This specialist deals with liver problems and neutralizing the effect of her pathologies on the body as a whole. The hepatologist is competent to diagnose and treat such liver and bile duct diseases as hepatitis (acute and chronic), cirrhosis, toxoplasmosis (rodent transfer), enterovirus hepatitis, infectious mononucleosis (Epstein-Barr's disease), leptospirosis (Weil-Vasiliev's disease) , jaundice, reactive hepatitis, alcoholic hepatitis, hepatitis B and C. Thus, the hepatologist, although a narrowly specialized specialist, but still a broad-spectrum doctor capable not only of treating liver and bile duct diseases, but also adjusting the condition yanie immunity.

Hepatologist advice

For the prevention of hepatitis B and C, you should not drink raw water from the tap, there are unwashed vegetables and fruits. It is always worth remembering that you need to wash your hands before eating and after visiting the restroom. Do not have sex without a condom, if one of the partners has hepatitis B or C, and also practice anal sex or sex during menstruation. If your work is related to blood (for example, you are a surgeon, dentist or medical laboratory assistant), do not forget to wear protective glasses before starting work, because infected blood, getting on the mucous eyes, immediately transfers the hepatitis virus.

If the patient is sick with cirrhosis, then he needs to monitor the regularity of the stool, which should be 2 times a day. It is also advisable to monitor the amount of liquid consumed and allocated (if you drink less than out of you "go out" - you need to sound an alarm and urgently go to the doctor). The common prevention of diseases of the liver and bile duct is a diet with a reduced content of acute, fried and fatty, and also with moderate alcohol consumption (or its complete absence in your diet: an exception can be a good red wine, in the calculation - one glass once a week). Take care of your liver and stay healthy!

It is important to know!

Glutamate dehydrogenase catalyzes the conversion of glutamic acid to alpha-ketoglutaric acid and ammonia; The enzyme is concentrated in the mitochondria of cells, mainly in hepatocytes. Read more..

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