What is Hepatology?
“Hepat” stands for Liver. Hepat- comes from the Greek hêpar, meaning “liver.”It is often used in medical terms. So a doctor who treats diseases that deals with liver, gallbladder, pancreas and bile duct is known as hepatologist.
Hepatology is a field that has emerged from gastroenterology. While some gastroenterology departments still house hepatology, the more liver-focused hepatology has begun to make a name for itself as an autonomous specialty with its own subspecialties. Hepatology is still in the process of establishing itself as an independent medical specialty and since the separation from gastroenterology is still in progress, many training/fellowship programs combine hepatology alongside gastroenterology.
Liver problems are a growing issue around the world, with conditions like cirrhosis, fatty liver disease, and chronic hepatitis and drug induced liver injury affecting the lives of millions of people each year.
What does a Hepatologist do?
Once a branch of gastroenterology, hepatology has now developed into its own medical field with its own subspecialties. A doctor who specialises in Liver diseases is considered a hepatologist or a liver doctor. Some of the most common health issues they treat include alcohol-related liver disease, fatty liver, hepatitis, and liver cancer. Hepatologists work to identify the cause with which liver is most affected, and to which degree, so they can diagnose the condition and identify the best treatment for it.
What is Transplant Hepatology?
It is a further sub speciality of hepatology. A doctor who deals with not just liver diseases but also as a part of the team that helps patient understand and prepare for liver transplant. He deals with managing pre, peri and post operative patients who need to undergo liver transplant. That in addition to hepatology entails training in immunosuppression management and dealing with complications of the same.
Education and Training of Hepatology in India
A person specialises in liver disease must go through either of the following path.
All doctors must go through 5 ½ years of MBBS training that includes internship. All of them then specialise in field of Internal Medicine for 3 years – known as Specialists. Then some may opt for a Hepatology degree after that which includes 3 years training. However, most of the individuals will undergo training in Gastroenterology for 3 years. Then they will opt to further super specialise in Hepatology by national and international training fellowships. This training may or may not include training in transplant hepatology.
Choosing gastroenterologist versus hepatologist
Both a gastroenterologist and a hepatologist can treat and diagnose liver disease. A gastroenterologist may very well be able to treat disorders of the liver. Although, a transplant hepatologist may be preferred to manage patients who suffer from end stage liver disease and may warrant a liver transplant in near future.Once a patient gets transplanted, he may choose to follow up on log term with the treating hepatologist or a gastroenterologist if he feels comfortable managing such patients.
Liver Disease in India
Liver diseases are fast being recognized as public health priorities in India. The burden of liver disease in India is significant because it alone contributed to 18.3% of the two million global liver disease–related deaths in 2015. Contribution of cirrhosis and its complications, collectively chronic liver diseases (CLDs), as a reason for dying in India have been increasing progressively since 1980, compared with China, the other country in Asia with a large population, where it remains stationary and is even showing downward trends.
If someone suffers from yellow urine, yellow eyes, swelling of feet, abdominal distension, low urine, altered behaviour, incidental fatty liver on ultrasound, excessive alcohol intake, liver cancer, liver mass or any symptoms of liver failure, they should contact their liver doctor or hepatologist.
