The hepatologist

Hepatology is a field of gastroenterology that works with various pathologies of the liver and biliary system. Hepatologists are engaged in the diagnosis, treatment and prevention of diseases such as hepatitis, hereditary liver diseases - hemochromatosis, drug damage, alcoholic and fatty liver damage.

What diseases are treated by a hepatologist

A hepatologist specializes in the diagnosis and treatment of liver diseases. He deals with various pathologies of this important organ, including:

• chronic viral hepatitis (e.g. hepatitis B, C, D, E);

• cirrhosis of various etiologies;

• fatty liver disease;

• autoimmune diseases;

• medicinal liver damage;

• hereditary diseases hemochromatosis.

The EMC Hepatology Center in Moscow offers comprehensive care to patients suffering from various liver diseases. We successfully work with pathologies at any stage, thanks to the use of advanced treatment methods. We use only evidence-based medicine techniques, in accordance with the recommendations of international experts (European and American Societies for the Study of Liver Diseases).

When to see a doctor

Here are the symptoms that are recommended to consult a hepatologist:

• jaundice (the appearance of a yellow tint to the skin, whites of the eyes, or mucous membranes);

• decreased appetite, bitterness in the mouth, frequent nausea or vomiting;

• an increase in the size of the liver, a feeling of discomfort or heaviness in the right upper abdomen;

• unpleasant sensations after heavy or fatty food, alcohol;

• discoloration of feces or urine;

• deterioration of general condition: constant fatigue, decreased energy, weight loss for no apparent reason;

• itchy skin;

• frequent swelling;

• changes in laboratory tests (such indicators as ALT, AST, GGT, bilirubin, alkaline phosphatase indicate organ dysfunction).

Many of the symptoms are non-specific, so it is difficult to recognize liver problems on your own. Usually, patients are referred to a hepatologist by doctors of various specialties – dermatologists, cardiologists, endocrinologists, rheumatologists, neurologists and internists.

Those who are at risk should regularly visit a hepatologist. These are patients who have previously suffered from liver disease. People who have close relatives with liver pathologies are also predisposed. For example, hereditary factors are important for Gilbert's syndrome and primary hemochromatosis.

Diagnosis of liver diseases

An appointment with a hepatologist begins with the collection of medical history. The doctor clarifies the patient's complaints and examines the abdominal area, skin, and mucous membranes. Then laboratory tests and ultrasound of the abdominal organs are performed. This is one of the most important methods of studying liver function. It can be used to assess the size and shape of organs, vascular pattern, and tissue condition. If there are signs of an inflammatory process, cysts, adenomas, foci of fatty degeneration, all this will be noticeable on ultrasound.

The next stage of diagnosis is CT. The doctor uses this method to clarify the diagnosis. For example, if an oncologist suspects the presence of neoplasms. CT is performed with intravenous contrast. For the same purpose, MRI can be used to determine the exact location and size of tumors.

Another diagnostic method is a liver biopsy. It is used only if there are serious grounds, for example, when combined pathologies are suspected. In the EMC Hepatology Center, the procedure is performed in one day, it is painless and safe. A puncture biopsy is performed under ultrasound control and with anesthesia.

Patients are also prescribed laboratory tests of blood, feces and urine. These are biochemical analyzes (liver, lipid profiles), cancer markers, genotyping of hereditary diseases, FibroTest, Fibromax. The EMC clinic has its own laboratory, so you can get the results of many tests in a few hours.

Treatment of liver diseases

The choice of a treatment strategy for liver diseases depends on the specific diagnosis and the degree of organ damage. Hepatology uses various techniques: drug therapy, endoscopic and laparoscopic operations, and in the most serious cases, organ transplantation.

At the EMC Hepatology Center, we offer advisory, diagnostic, and therapeutic assistance at every stage. The clinic's doctors treat liver diseases of various etiologies: hepatitis of various etiologies, autoimmune diseases, cross syndrome, hemochromatosis. We work according to international protocols, taking into account all clinical recommendations. Hepatologists work together with oncologists, surgeons, endocrinologists, dermatologists, and therapists to ensure that treatment is as effective as possible.

If you experience any symptoms related to impaired liver function or have already been diagnosed, we recommend that you contact a hepatologist for professional advice and a choice of therapies. A team of experienced specialists is waiting for you at the EMC Hepatology Center, ready to provide comprehensive care and develop an individual treatment plan.

List of sources and literature

1. Tsapok P. I., Yelikova E. P., Tukmachev A. G., Karavaev S. A. Biochemical syndromes in modern hepatology // Vyatka Medical Bulletin. 2002. No. 1.
2. Zhuravlev V.A. Surgical hepatology: results and prospects // Vyatka Medical Bulletin. 2001. №1.
3. Krstić MN, Mijač D, Tomašević RS, Lukić S, Stojković Lalošević M, Krstić JM, Milosavljević T. Abnormal Liver Blood Tests: Hepatologist Approach. Dig Dis. 2022;40(2):206-214. doi: 10.1159/000517110. Epub 2021 May 10. PMID: 33971644.
4. Rimbaş M, Di Maurizio L, Rizzatti G, Gasbarrini A, Costamagna G, Larghi A. Endoscopic Ultrasound for the Hepatologist: A Comprehensive Review. Semin Liver Dis. 2018 May;38(2):145-159. doi: 10.1055/s-0038-1656511. Epub 2018 Jun 5. PMID: 29871020.