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Liver problems, such as fatty liver disease, cirrhosis, hepatitis, and liver cancer, occur worldwide. In the United States alone, roughly 4.5 million adults have some type of diagnosed liver disease. If a person receives a diagnosis of a liver condition, they may need the expertise of a hepatologist. These healthcare professionals are experts in diagnosing and treating liver conditions, and helping to prevent further liver injury and damage. In this article, we will discuss what hepatologists do, when a person may need to contact one, and what to expect during their appointments. Definition Share on PinterestCarol Yepes/Getty ImagesHepatologists are doctors who specialize in diagnosing and treating various conditions associated with the liver and biliary system. This area of study is known as hepatology. Traditionally, experts consider hepatology a subspecialty of gastroenterology. However, it is quickly emerging as a distinct entity from gastroenterology due to the advances in the understanding and treatment of the liver. To become a credentialed hepatologist, a person undergoes a process that typically requires the following:a bachelor’s degree4 years of medical school to receive their Doctor of Medicine or Doctor of Osteopathic Medicine degree3-year residency in internal medicine3-year fellowship in gastroenterology and a 1-year fellowship in advanced and transplant hepatology or a 3-year joint fellowship in gastroenterologya certification exam from the American Board of Internal Medicine for both transplant hepatology and gastroenterology What do they do Hepatologists diagnose and treat all disorders associated with the liver. These can include:hepatitishepatic encephalopathynonalcoholic fatty liver diseasenonalcoholic steatohepatitiscirrhosisliver damageliver cancerfatty liver diseasemetabolic liver diseases Additionally, a hepatologist may also help treat other conditions affecting the hepatic and biliary system, such as:primary biliary cholangitisprimary sclerosing cholangitisgallstonesgallbladder cancerpancreatitispancreatic cancergallbladder inflammationbile duct stonesnoncancerous tumorsbile duct cancer Hepatologists can also: perform diagnostic testsexplain a person’s treatment optionsprovide treatmentmonitor individuals who will have liver surgery, such as a liver transplantrefer a person to other specialists for further assessment and treatmentwork with other experts to offer the best care Hepatologists may see individuals in their clinic and do consultations for people in hospital. They may also work in intensive care units, high dependency units, or liver specialist centers. When does a person need a hepatologist Doctors typically refer people to hepatologists for more specialized care. A general practitioner or other healthcare professional may refer a person to a hepatologist if the person has a recent diagnosis of a liver condition that requires specialist treatment. Sometimes, a doctor may refer an individual if they cannot make a diagnosis or if they show signs or symptoms that may be due to an underlying liver problem, including:abnormal liver function test resultsgastrointestinal bleedingjaundicedeep yellow or brown-colored urineascitesenzyme problemsdrug overdose What to expect The hepatologist will typically spend time discussing and assessing a person’s general health and symptoms. This may involve a physical exam and reviewing recent test results. They may then recommend further tests to help them assess the person’s liver function and identify a potential diagnosis. Further tests may include:blood tests to examine liver function and detect signs of infection or genetic markersimaging scans and tests to identify stones, cysts, and tumorsbiopsies Once they reach a diagnosis, they will explain a person’s treatment options and may prescribe medications and certain lifestyle changes. Hepatologists may also refer individuals to surgeons if the person’s condition requires surgery. Common procedures they perform Some procedures hepatologists commonly perform include the following:Imaging tests: These may include ultrasounds to look for gallstones and suspicious growths on the hepatic organs.FibroScan: This is to assess the stiffness of the liver.Cholescintigraphy scans: Also called hepatobiliary iminodiacetic acid scans, these use radiotracers to help take pictures of the biliary system and monitor bile production.Endoscopic retrograde cholangiopancreatography (ERCP): This uses a combination of endoscopy and X-rays to look for problems in the bile and pancreatic ducts.Transhepatic pancreato-cholangiography: This is another procedure that uses an injected contrast to take clearer images of the ducts, especially when ERCP is not an option.Portal pressure measuring: Hepatologists use this to diagnose portal hypertension.Transjugular intrahepatic portosystemic shunt: This approach involves placing a stent that connects two veins within the liver. This relieves high blood pressure in the portal vein.Liver biopsies: Done to remove a sample of liver tissue to help diagnose conditions. How to get a referral A person’s healthcare professional will typically refer them to a hepatologist if needed. Results from blood tests, imaging, scans, or physical exams, can warrant a referral to a hepatologist. The healthcare professional may also refer them to a specialist based on their symptoms, risk factors, personal, family, or medical history. A person may also contact a local hepatologist without a referral from their doctor. However, it is best for a person to communicate with their doctors, especially if they are unsure whether their symptoms relate to the liver. Once a person receives care from a hepatologist, the hepatologist will work closely with the person’s doctor. Summary Hepatologists are medical doctors trained and certified to diagnose and treat various liver conditions. A person at risk of liver problems or who is experiencing symptoms of liver disease may consider contacting their healthcare professional for a referral to a hepatologist. Typically, the earlier a person receives a diagnosis and treatment for a liver condition, the better their outlook will be. Last medically reviewed on July 6, 2022Liver Disease / HepatitisMedical Students / Training 11 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Biliary system anatomy and functions. (n.d.).https://www.hopkinsmedicine.org/health/conditions-and-diseases/biliary-system-anatomy-and-functionsChronic liver disease and cirrhosis. (2022). https://www.cdc.gov/nchs/fastats/liver-disease.htmGastroenterology (includes sub-specialty of hepatology). (n.d.).https://www.jrcptb.org.uk/specialties/gastroenterology-includes-sub-specialty-hepatologyGastroenterology: Certification examination blueprint. (2022).https://www.abim.org/Media/fxanboc2/gastroenterology.pdfHepatology (liver care). (n.d.).https://www.hopkinsmedicine.org/gastroenterology_hepatology/specialty_centers/hepatology.htmlLuxon, B. A. (2013). So you want to be a hepatologist?https://www.gastrojournal.org/article/S0016-5085(13)01497-2/fulltextRaven, K., et al. (2020). Which specialist do I need? Maybe a doctor you didn't know existed.https://www.yalemedicine.org/news/which-specialist-do-i-needSadowski, B. W., et al. (2019). Pursuing a career in hepatology: Considerations for gastroenterology fellows.https://journals.lww.com/acgcr/fulltext/2019/05000/pursuing_a_career_in_hepatology__considerations.19.aspxThe complete guide to becoming a hepatology doctor. (2021).https://www.bmj.com/careers/article/the-complete-guide-to-becoming-a-hepatology-doctorTransplant hepatology: Certification examination blueprint. (2022).https://www.abim.org/Media/lo0jcigs/transplant-hepatology.pdfYoung, M., et al. (2022). Percutaneous transhepatic cholangiogram.https://www.ncbi.nlm.nih.gov/books/NBK493190/FEEDBACK:Medically reviewed by Kelsey Trull, PA-C — By Rachel Ann Tee-Melegrito on July 6, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? 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