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Who is a Hepatologist?

A doctor who specializes in Hepatology—the study of diseases that infect the liver, gall bladder, biliary tract, and pancreas, is called a Hepatologist. A hepatologist focuses on diagnosing and treating patients whose liver and other aforementioned organs are affected by hepatic disease.

In the beginning, it was treated as a subspecialty of gastroenterology but advancements, studies and researches in the last few decades have allowed hepatology to emerge as a specialty in its own right. It still remains closely connected with its parent field given the fact that it involves parts of the gastrointestinal (GI) tract that includes the esophagus, intestines, rectum and any other part that has anything to do with the process of digestion.

In simple words, a hepatologist treats and manages the hepatic disease and any organ that it can affect.

When should you see a Hepatologist?

You must consult a doctor if you have any of the symptoms below:

• Incessant abdominal pain
• Swelling in the abdominal region
• Loss of appetite
• Fatigue or tiredness that doesn’t go even after you have taken ample rest
• Unexpected weight loss
• Urine that is either has blood or is too dark
• Stool (poop) is bloody or dark
• Diarrhea that would persist for more than 2-4 weeks
• Nausea (feeling of discomfort that makes you want to puke) or vomiting
• Jaundice (your skin and eyes go yellow from white)
• Accelerated heart rate
• Low-grade fever (between 98.7°F and 100.4°F or 37.5°C and 38.3°C)
• Swelling at the ankles or legs

Closely observing your symptoms and medical history, your general care physician will decide whether to opt for a hepatologist or a gastroenterologist. You’ll seek consultation from a hepatologist for the abnormalities in the liver and related areas.

Note: If you have been referred to get a liver transplant by your GP, you go for a gastroenterologist who is an expert in hepatology. If you’ve already undergone a liver transplant and you are on treatment of immunosuppression (suppression of body’s immune system by intentional induction of drugs in order to prevent organ rejection)

What are the most common hepatic concerns in Pakistan?

On World Hepatitis Day 2019, World Health Organization (WHO) announced that there are 15 million people in Pakistan who have been affected with hepatitis, 90% of them are unaware that they have the infection:

A report published in Express Tribune suggests that the mortality rate stands at around 4% that accounts for 120,000 deaths each year due to the infection. This implies 325 deaths every day as compared to the highest daily death toll due to COVID-19 recorded to be 153.

As per the news “World Hepatitis Day 2021: Hepatitis can’t wait” by the WHO EMRO, Pakistan has the highest prevalence of Hepatitis C (5%) globally, which is only second to China.

According to the “Frequency of Hepatorenal Syndrome among Patients with Cirrhosis and Outcome after Treatment” Hepatorenal syndrome is the third most common cause of admissions among patients with liver cirrhosis.

What are the main areas of concern for a Hepatologist?

Liver specialists more than often deals with viral hepatitis that might, unfortunately, lead to liver cancer and liver transplant. A considerable chunk of their focus is also diverted to fatty liver disease and pancreatitis.

What kinds of Hepatologists are there?

When looking for an apt treatment for your hepatic issue, you tend to choose from the following considering the seriousness of your condition, as recommended by your general care physician:

Gastroenterologist

A doctor who is certified not only in internal medicine but gastroenterology focusing on the disorders pertaining to the digestive tract, from the esophagus to the rectum and pancreas, gallbladder, bile ducts and the liver.

Hepatologist

A hepatologist is a doctor who is specifically dedicated to dealing with the issues of the liver and the related organs—the pancreas and the gallbladder.

Transplant Hepatologist

Hepatologist who is trained for advanced liver diseases and liver transplants.

How to become a Hepatologist in Pakistan?

You would have to pass through the following stages in order to become a hepatologist:

• Complete your MBBS from a medical college accredited by the Pakistan Medical and Dental Council (PM&DC)
• One-year house job in an institution recognized by the College of Physicians and Surgeons Pakistan (CPSP) with six months dedicated to gastroenterology
• Fellowship in hepatology or transplant hepatology (FCPS)

Once you have become a certified gastroenterologist, you must thenceforth dedicate the majority of your focus on liver and relevant complications in order to enhance your expertise.

You can also opt to pursue your studies abroad for specialization and certifications like FRCS, MRCGP, etc.

What are Hepatologists called in Pakistan?

• Liver Specialist
• Liver Doctor
• Liver Transplant Surgeon
• Mahir-e-Amraz-e-Jigar
• ماهر امراض جگر