Hepatologist

A hepatologist is a doctor whose professional activity is aimed at diagnosing and treating diseases of the liver. Hepatology is a branch of gastroenterology that focuses on the problems of the liver, gallbladder and biliary tract. A separate area of ​​medicine is pediatric hepatology, which takes into account the structure of the liver, its development and pathology in the child’s body.

What liver problems does a hepatologist consult

Consultation with a hepatologist is necessary for patients with liver diseases. A hepatologist diagnoses diseases as well as pathologies associated with the liver: metabolic syndrome and obesity, dietary, endocrinological, hematological and cardiological problems and treats them by prescribing drug therapy to patients combined with a special diet.

For the most part, all diseases of the biliary tract and liver are very dangerous and severe, their treatment is usually long-term, and sometimes lifelong. That is why it is necessary to follow the doctor’s prescriptions with all seriousness, not forgetting not only to take drugs, but also to adhere to the diet and behavior regimen prescribed by the hepatologist.

A hepatologist should be contacted by persons suffering from such diseases as acute or chronic hepatitis, cirrhosis of the liver, liver disease with alcohol dependence, herpetic hepatitis, toxoplasmosis, cholelithiasis, cytomegalovirus hepatitis, cholangitis, non-alcoholic steatohepatitis, enterovirus hepatitis, nonspecific reactive, autoimmune hepatitis, toxic hepatitis, hemochromatosis, hepatitis C, Gilbert’s syndrome or disease.

If during the diagnosis of oncological diseases of the liver, the hepatologist gives the patient a referral to an oncologist. If other related diseases of the gastrointestinal tract are detected, the specialist may recommend that you seek additional advice from a gastroenterologist.

Examination and treatment

Reception of a hepatologist always begins with the clarification of the patient’s complaints and the determination of the symptoms of the disease, with the obligatory consideration of hereditary factors.

Also, the hepatologist always pays attention to the patient’s lifestyle. For example, alcoholism exacerbates various liver diseases, and the outcome is aggravated. For the differential diagnosis of the patient’s diseases, the hepatologist prescribes a comprehensive laboratory examination, which may include:

• general blood analysis;
• blood chemistry;
• general urine analysis;
• coagulogram;
• analysis for markers of hepatitis C and B by ELISA;
• qualitative and quantitative blood test for hepatitis B and C by PCR;
• analyzes of metabolic processes of iron and copper;
• research of autoantibodies;
• determination of markers of liver tumors.

Also, for the diagnosis of liver diseases, ultrasound examination of the liver, esophagogastroduodenoscopy, determination of Helicobacter pylori, colonoscopy, radioisotope diagnosis of the liver, detailed blood test, fecal analysis for the determination of stercobilin, computed and magnetic resonance imaging, analysis for the presence of Epstein-Barr virus, herpes simplex can be used , cytomegalovirus, electroencephalography.

If necessary, a liver biopsy is performed under local anesthesia with a short hospitalization after the procedure.

Based on the diagnosis, the hepatologist prescribes a specific treatment for diseases, guided by several important principles:

• the need for complex antiviral therapy, which will not only help alleviate the symptoms of the disease, but also eliminate the cause of its occurrence;
• the use of additional treatment, which necessarily takes into account all the patient’s chronic diseases (cardiovascular diseases, diseases of the genitourinary system, etc.);
• in treatment, it is necessary to adhere to a special diet, otherwise the therapy will be ineffective. Most often, for liver diseases, hepatologists prescribe diet No. 5.

Symptoms of diseases

The most common liver diseases are cirrhosis and chronic hepatitis C. You should consider the symptoms of each of them separately, for a clear understanding of what factors indicate the development of these serious diseases.

Symptoms of cirrhosis of the liver depend on the stage of the course. At the initial stage, the symptoms are very mild, but they need to be focused on. According to clinical experience, the treatment of liver cirrhosis in the early stages gives much better results in terms of preserving the organ and restoring the function of the liver tissue. Moreover, with the right approach, it is possible to stimulate the regeneration and restoration of liver cell function.

Among the main symptoms, hepatologists call soreness in the right hypochondrium, an increase in the liver in volume, bleeding gums, mood swings, decreased concentration, drowsiness and fatigue of the patient. With cirrhosis of the liver, sexual function also suffers, libido decreases, the skin acquires a yellow tint. Feces become light, and urine, on the contrary, darker. If these symptoms occur, or even some of them, you should immediately seek the advice of a specialist in order to avoid the progression of cirrhosis and disastrous consequences in the future.

The second most serious disease that is included in the scope of treatment of a hepatologist is chronic hepatitis C, which may not show any symptoms at all for a long time. The development of hepatitis C and its transition to a chronic form can continue in a latent form for about 25 years, which does not allow timely detection of signs of the disease and influence its development.

If symptoms do occur, they are expressed by pain in the abdomen, weight loss, appetite, general weakness. There may be itching and rashes on the body. Sometimes hepatitis C affects not only the liver, but also other vital systems of the body, such as the endocrine, circulatory, central nervous systems, blood vessels, muscles, kidneys and joints. Therefore, the slightest ailments should be treated very carefully and try to prevent the development of the disease, and immediately consult a doctor to find out the reasons for feeling unwell.

Hepatologist’s recommendations

Experts draw the attention of relatives that patients with cirrhosis of the liver may develop nervousness and incontinence, as well as decadent moods caused by the disease, which must be taken, since they are caused not only by awareness of their own disease, but also by its manifestations.

The patient needs to be provided with more rest, he should not be allowed to do heavy physical exercises, lift weights, since with cirrhosis they can cause gastrointestinal bleeding.

With cirrhosis, it is necessary to adjust the patient’s nutrition, controlling regular stools, and urination. In case of any violations of the excretory processes, it is necessary to immediately notify the hepatologist about this so that the doctor can adjust the treatment. For the same purpose, the patient is measured daily for the weight and volume of the abdomen, and with a sharp increase in these indicators, they also consult a doctor urgently.

Attention should be paid to the prevention of viral hepatitis, since pathogens circulate in the environment. Do not drink unboiled water, neglect the washing of food and their heat treatment, regular hand washing. These simple hygiene rules will help protect yourself from hepatitis A. Also, to prevent hepatitis B and C infections, it is necessary to exclude contact with the biological fluids of other people (blood, urine). Blood, for example, in microscopic quantities can remain on personal hygiene items, so it is not recommended to use other people’s razors, toothbrushes, washcloths.

The clinic is taking measures to prevent nosocomial infection of patients with hepatitis. However, even 10 years ago, methods of dealing with hepatitis were not so common, so you should check with a hepatologist if a person has previously treated a tooth or underwent an endoscopy.

It must be remembered that it is absolutely impossible to use common syringes and needles, make tattoos and piercings in non-sterile conditions. The viruses that cause hepatitis are highly resistant and can persist in the environment for up to 2 weeks.

You can get hepatitis and sexually. This is how hepatitis B is transmitted, but sometimes you can also become infected with hepatitis C during sexual intercourse. Hepatitis can be passed from a mother to a newborn or breastfeeding baby.

Today, there are quite a lot of all ways of infection with this disease, so immunologists and hepatologists strongly recommend getting vaccinated against this terrible disease. Vaccinations against hepatitis A and B are currently being carried out.

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