Hepatology

Many liver diseases are preventable through changes in your lifestyle or diet. Should you have a family history of liver disease, regular screenings can ensure early detection of disease.

What Does A Hepatologist Do?

Hepatologists specialise in the health of the hepatobiliary system - which includes your liver, gallbladder, pancreas and biliary tract.

Hepatologists are also involved in the planning and execution of liver transplants.

Symptoms To Look Out For

There are certain tell-tale sights that something is wrong with your liver, including:

• Yellowing of the skin and eyes, known as jaundice, is the most common symptom of liver dysfunction
• Persistent pain in the upper right side of the abdomen
• Extreme tiredness or weakness without a clear cause
• Fever
• Nausea
• Dark urine

If you have a family history of liver disease or a genetic condition related to the liver, you might be at greater risk.

Once you visit a doctor, they might call for some tests, which could indicate problems with your liver, gall bladder or bile ducts.

How Do They Test For Liver Diseases?

Your doctor will start out by asking about your symptoms, your medical and family history. They will gauge if you have any risk factors related to liver disease, such as your level of alcohol consumption and your BMI.

They will then perform a medical exam to check for jaundice, an enlarged liver, or abdominal tenderness.

Should your doctor suspect a liver condition, they will request blood tests. For suspected viral liver infections, such as hepatitis A, B or C, blood tests detect the presence of viral antigens or antibodies. Liver function tests measure how well your liver is working overall and include liver enzyme tests, tests for bilirubin levels, albumin levels, and prothrombin time.

In autoimmune liver diseases like autoimmune hepatitis, blood tests detect autoantibodies that attack the liver cells.

Problems with your liver might also show up on medical imaging such as ultrasound, CT scan, and MRI.

The doctor might use FibroScan or Transient Elastography to determine the severity of liver disease, especially in conditions like hepatitis. These tests are non-invasive and measure liver stiffness, fibrosis and scarring.

In some cases, a liver biopsy may be necessary. A small sample of liver tissue will be taken and examined under a microscope.

What Are The Most Common Causes Of Liver Diseases?

Liver conditions are most often caused by lifestyle factors such as diet and drug use, viral infections, cancer or genetic conditions.

• The most common types of viral infections that affect the liver are hepatitis A, B, and C. These infections can lead to inflammation and liver damage.
• Chronic and heavy alcohol use can cause inflammation, fat accumulation, and eventually cirrhosis (scarring) in the liver.
• Non-alcoholic fatty liver disease (NAFLD) occurs when fat builds up in the liver, leading to inflammation and damage. It is often associated with conditions such as obesity, diabetes, high cholesterol, and metabolic syndrome.
• Autoimmune diseases occur when the body's immune system mistakenly attacks healthy cells in the liver. Examples include autoimmune hepatitis, primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC).
• Genetic or metabolic diseases can lead to liver damage, including Wilson's disease, alpha-1 antitrypsin deficiency, and hemochromatosis.
• Drug-induced liver injury can be caused by certain medications and herbal supplements. Common medications that can cause liver damage include the overuse of paracetamol and NSAIDS. Herbal remedies in high doses can also cause liver damage, including kava, comfrey, and black cohosh.
• Biliary diseases such as gallstones, primary biliary cholangitis, and primary sclerosing cholangitis.
• Liver cancer (hepatocellular carcinoma) and bile duct cancer (cholangiocarcinoma) are serious conditions that can lead to liver disease. The liver is a common site for cancers that metastasise from other parts of the body.

How Can I Prevent Liver Diseases?

Many liver diseases can be prevented or managed through lifestyle modifications such as maintaining a healthy weight, eating a balanced diet, limiting alcohol intake, avoiding illicit drugs, and being cautious with the use of medications and supplements. Practising safe sex and exercising regularly can also decrease your chances of contracting liver disease.

Regular check-ups and screenings can help detect problems early on and are particularly important if you have a family history of liver disease.

Frequently Asked Questions