Malfunctions of the liver and gallbladder are studied by hepatology. Hepatologists at our clinic treat hepatitis, cirrhosis, cholecystitis, tumor neoplasms, diseases of the biliary tract and much more. The clinic performs a thorough examination to establish an accurate diagnosis, as well as identify the causes of the disease. Next, our qualified doctors select the appropriate treatment method. We use the latest equipment. If you are concerned about hepatological problems, we are guaranteed to help you get rid of them.
How to find your clinic and your doctor?
Option 1 - choose based on reviews.
Modern and smart. Many people do this. However, besides “I like everything, they helped me a lot, everything is very good” or “they didn’t help me, everything is bad, don’t go there,” is there anything specific in them? What was actually examined, how was it treated, with what regimens, what specific result did you get? In order to give correct feedback, you need to understand the problem. Everyone understands that situations are different, each patient is individual, so what is good for one may be unacceptable for another. Option 2 - listen to a friend, relative, acquaintance. Really a real option. If he, your friend, relative or acquaintance is directly related to medicine, then you are in luck, seek advice and draw conclusions. And if not? Then the advice is more like the feedback from the previous paragraph.
Option 3 - search on the Internet - on the websites of various clinics offering hepatologist services. But how to choose when they write everywhere that they have the most wonderful doctors and the latest equipment?
Is there another option - how to make an informed decision, based not only on emotions, external signs of success and positive reviews? Let's talk about this.
Diagnostic tests prescribed by the hepatologist
In order to confirm the diagnosis assumed during a conversation with the patient and his examination, the hepatologist may prescribe the patient a set of laboratory tests:
- general (or clinical) blood test;
- biochemical blood test;
- general clinical urine analysis;
- urine analysis for biochemistry;
- stool test for stercobilin;
- blood and urine test for hemoglobin;
- tests aimed at identifying certain infections (Epstein-Barr virus, cytomegalovirus, herpes infections).
In addition to laboratory tests, a hepatologist may prescribe the following instrumental studies:
- examination of the liver and adjacent organs using ultrasound;
- computed tomography of the liver area;
- magnetic resonance imaging of the liver area;
- taking a liver biopsy (obtaining liver tissue through a puncture of the abdominal wall with a special needle, which is performed under local anesthesia, after which the patient is left in the hospital for several hours under observation);
- electroencephalography - a study of the brain if encephalopathy associated with liver dysfunction is suspected.
How to understand who is treating the liver?
Isn't the liver part of the gastrointestinal tract?
The liver is not directly related to the gastrointestinal tract. Together with the gallbladder, it represents an independent hepatobiliary system, which, from an anatomical point of view, is distinguished separately. The liver is a unique organ that not only participates in the digestion process, but also performs many vital functions. Therefore, it is called a biochemical laboratory and a detoxification center for the body.
Shouldn’t it be necessary to contact a gastroenterologist when detecting changes in blood tests of liver parameters ALT, AST, bilirubin?
Usually, when AST and ALT increase, the patient begins a long journey: first to an infectious disease specialist, then a gastroenterologist, a therapist and back, until one of the doctors (or the Internet) suggests: “You should find a good hepatologist.” And then the patient learns that, it turns out, there is such a medical specialty.
Who is a hepatologist? What does he do?
A hepatologist is a specialist who solves all liver problems, as well as interdisciplinary liver pathology: combination with metabolic syndrome and obesity, nutritional, endocrinological, hematological, cardiological problems. Having special deep knowledge in the treatment of the liver, such a doctor will help cope with any diseases of the hepatobiliary zone: viral, non-viral, rare, difficult to diagnose.
Can any doctor be a hepatologist?
In order to become a hepatologist, you need special education and skills, because... Hepatology is a special, dedicated section of gastroenterology and infectious diseases. Hepatology begins with general therapy, followed by specialization in gastroenterology and infectious diseases. This is a specific area that includes both viral and non-viral liver diseases. During his education, a hepatologist also studies the latest methods of diagnosis, treatment, and prevention of liver and gall bladder diseases.
What liver problems does a hepatologist solve?
A hepatologist resolves issues of diagnosis and treatment of all liver diseases of infectious and non-infectious nature, such as:
- viral hepatitis B and C
- non-alcoholic fatty liver disease (NAFLD)
- alcoholic liver damage
- autoimmune diseases
- hereditary metabolic disorders (Westphal-Wilson-Konovalov disease, hemochromatosis)
- medicinal hepatitis.
When should you contact a gastroenterologist?
Diseases of the liver, biliary tract, and gallbladder are accompanied by certain symptoms. Symptoms that require you to contact a hepatologist are as follows:
- nausea
- discomfort, heaviness or pain in the right hypochondrium
- bitterness in the mouth
- loss of appetite
- yellowing of the skin and sclera (whites of the eyes)
- itchy skin
- ascites (excess fluid in the abdominal cavity)
- urine too dark
- grayish white stool
- bloody vomiting.
What diseases may your symptoms indicate?
The above symptoms may accompany various diseases of the gallbladder and liver, namely:
- hepatitis: autoimmune, hepatitis C, chronic viral B, C, D, toxic hepatitis, non-alcoholic steatohepatitis.
- primary biliary cirrhosis.
- alcoholic liver disease.
- liver cirrhosis of any etiology.
- hereditary hemochromatosis (excessive iron accumulation).
- primary sclerosing cholangitis.
- cholelithiasis.
- Wilson-Konovalov disease.
- chronic cholecystitis.
- fatty hepatosis.
- biliary dyskinesia.
What is important to pay attention to when choosing a clinic and doctor?
What is the main profile of the medical institution where the hepatologist works?
If this is a specialized center specializing in the treatment of patients with liver diseases, this is the place for you. If not, additional information should be collected. The profile of the center is reflected in its services. It is important to evaluate:
- Does the clinic (medical center) have all the necessary laboratory and special examination methods so that you can be examined “here and now”?
- Is it possible to obtain an assessment of the stage of liver disease (fibrosis), including non-invasively - ultrasound with elastography?
Does the specialist have sufficient experience in managing patients with liver diseases?
Effective acquisition of such experience is possible only within specialized centers, where the doctor not only consults the patient, but treats and monitors his health and the health of his family members for a long time. Only in this case does the hepatologist have sufficient experience in managing patients with viral, non-viral diseases and their combinations.
How many hepatologists work in the center, do they have status and academic title?
The answer to this question will allow you to:
- be sure that in the event of vacation, illness or absence of your attending physician for any other reason, you will not be left without proper help and attention at the moment of a sudden exacerbation of the disease
- count on a consultation if there are hepatologists at the center, if your case is complex, as well as on the treatment and supervision of a professor at the stages of particularly complex treatment
- be confident in the high level of quality, the presence of principles of continuity and team support in both diagnosis and treatment in this center.
Does the medical center have a professional team of hepatologists?
Rate the level of professionalism and experience of the center’s specialists:
- Does the team include doctors, candidates of medical sciences?
- Is there a leader, a “senior colleague” who is responsible for the professional level of all employees of the clinic, which will allow them to confidently contact any doctor, since uniform diagnostic and therapeutic standards have been introduced into the team?
- What is the experience and academic titles of the “senior colleague”?
- Will he be able to provide insurance if you have a difficult case?
Clarify to what extent the clinic’s specialists are proficient in the most modern diagnostic and treatment methods, and to what extent their prescriptions comply with international standards:
- Are there any employees from departments of state medical educational institutions in this medical center?
- Are there training centers based at the clinic?
- Do the center’s staff participate and speak at conferences on hepatology and gastroenterology?
- are they working on scientific publications on hepatology?
- Are other doctors trained in hepatology?
Are there doctors of other specialties in the clinic?
Find out how holistically the hepatology department is represented in the medical center, that is, the opportunity to treat pathology of internal organs combined with the liver is provided. Since the treatment of liver diseases often affects other organs and systems, the complex approach of a hepatologist to problems in the patient’s body requires the participation of such specialists as:
- endocrinologist
- cardiologist
- psychotherapist.
What does an appointment with a hepatologist involve?
The doctor treating the liver begins his consultation with a questioning of the patient, during which he finds out what he is complaining about. During a conversation with the patient, the doctor can definitely clarify the likelihood of a predisposition to liver pathology - such a conclusion can be made if there are similar liver lesions in the patient’s closest relatives. When talking with a patient, the doctor pays attention to the patient’s lifestyle, work habits, food preferences and bad habits, as well as any other factors whose influence may determine the occurrence and course of liver diseases.
After the interview, the doctor who treats the liver conducts a detailed examination of the patient, paying attention to the condition of the sclera and skin, its color, the presence of hemorrhages, spider veins, capillary networks, scratching and peeling. During the examination, the doctor palpates the liver area, taking into account the density of the organ, the condition of its edge, the soreness of the liver itself and some points of the anterior abdominal wall. Laboratory and instrumental studies complement the results of the survey and examination.
We wish you good health!
And if you need liver examination and treatment, our specialists are always ready to help. We guarantee:
- high level of expertise in diseases of the hepatobiliary system
- extensive successful clinical experience in managing patients with liver diseases
- presence of a team of hepatologists
- work according to international standards of leading hepatological communities
- availability of highly specialized laboratory and instrumental equipment
- possibility of a comprehensive liver examination based on the “here and now” principle
- individual approach to each patient.
Treatment of cirrhosis
Liver cirrhosis is a progressive liver disease characterized by a progressive decrease in the number of hepatocytes (liver cells). Treatment of liver cirrhosis involves eliminating the cause of the disease. Thus, in case of alcoholic cirrhosis, any alcoholic drinks must be excluded; in case of viral cirrhosis, antiviral treatment is prescribed. The choice of treatment regimen can only be made by a doctor, based on the patient’s medical history. If drug treatment does not produce the desired result, patients are placed on a waiting list for liver transplantation. Treatment for cirrhosis is usually aimed at preventing liver cancer. There are numerous possible complications that often accompany cirrhosis.
Innovative techniques in diagnostics and therapy
Today, all our patients have access to the following latest research and diagnostic methods:
- CT and MRI on the latest generation Philips tomographs to clarify the clinical and morphological form of the disease;
- Ultrasound - to identify chronic and acute diseases of the gallbladder and liver;
- biopsy under ultrasound control - for in-depth examination of tissues and clarification of the diagnosis;
- fibroelastography - to detect liver fibrosis at an early stage and assess its level;
- hemocorrection in the treatment of autoimmune hepatitis - purification of blood outside the patient’s body; cascade filtration of plasma and cryopheresis - removal of autoimmune antibodies from the blood;
- endoscopy (gastroscopy and colonoscopy) can be performed in a state of sedation (superficial sleep) at the request of the patient.
In addition to instrumental diagnostics, each patient is prescribed and carried out a full range of laboratory tests in a modern diagnostic laboratory.
The specialists of the department are always aware of world trends, since they themselves constantly improve their professional level and monitor new methods of diagnosis and therapy. They select and use the most effective and safe treatment regimens for pathologies of the liver, gallbladder and biliary tract, based solely on the principles of evidence-based medicine.
