Specialists Focusing on the Liver: Their Role and Patient Experience
In the realm of healthcare, a hepatologist plays a crucial role in diagnosing and treating a wide array of conditions related to the liver. When a person's healthcare professional suspects a liver issue, they may refer the individual to a hepatologist. This referral could stem from abnormal liver function test results, gastrointestinal bleeding, jaundice, or other symptoms.
Once a person receives care from a hepatologist, they will work closely with their general practitioner. The hepatologist will assess the person's general health and symptoms, often through a physical exam and review of recent test results. They may perform various procedures, such as ultrasounds, FibroScan, cholescintigraphy scans, ERCP, transhepatic pancreato-cholangiography, portal pressure measuring, transjugular intrahepatic portosystemic shunt, and liver biopsies, to better understand the condition.
Hepatologists are specialists in the field of hepatology, which encompasses the diagnosis and treatment of various conditions associated with the liver and biliary system. They can be found in clinics, hospitals, intensive care units, high dependency units, or liver specialist centers. A person may contact a local hepatologist without a referral from their doctor, but it is always best to communicate with their doctors if they are unsure whether their symptoms relate to the liver.
The pathway to becoming a certified hepatologist in the United States is a rigorous one. After completing a bachelor's degree, a person must attend and graduate from an accredited medical school to obtain an MD or DO degree. Following this, they must finish a 3-year accredited Internal Medicine residency program to become board-eligible/certified in Internal Medicine.
Next, they enroll in and complete a 2-3 year fellowship in Gastroenterology that is accredited by the Accreditation Council for Graduate Medical Education (ACGME). This training covers advanced knowledge and skills in digestive diseases, including the liver. Many hepatologists then pursue further specialized training or a fellowship in hepatology, especially if focusing on transplant hepatology or complex liver diseases.
After completing the Gastroenterology fellowship, they become board-certified in Gastroenterology through the American Board of Internal Medicine (ABIM). They then seek certification or eligibility in Hepatology. The ABIM offers a subspecialty certification in Transplant Hepatology, which requires board certification/eligibility in Gastroenterology and completion of an ACGME-accredited transplant hepatology training program.
In addition to these steps, hepatologists must obtain medical licensure in the practicing state and meet hospital credentialing requirements.
The earlier a person receives a diagnosis and treatment for a liver condition, the better their outlook will be. Hepatologists are experts in diagnosing and treating a wide range of disorders associated with the liver, including hepatitis, hepatic encephalopathy, nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, cirrhosis, liver cancer, and metabolic liver diseases. They also treat conditions affecting the hepatic and biliary system, such as primary biliary cholangitis, primary sclerosing cholangitis, gallstones, gallbladder cancer, pancreatitis, pancreatic cancer, gallbladder inflammation, bile duct stones, noncancerous tumors, and bile duct cancer.
In summary, hepatologists are vital healthcare professionals who specialize in liver health. Their expertise ensures comprehensive knowledge of the liver and gastrointestinal system, making them invaluable in diagnosing and treating a wide range of liver conditions.
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