hepatology

Hepatology is a medical specialty within gastroenterology that focuses on diseases of the liver and the biliary system. It encompasses the evaluation, diagnosis, treatment, and prevention of liver disorders, as well as the care of patients with liver failure and the consideration of liver transplantation.

Common conditions managed in hepatology include viral hepatitis (hepatitis B and C), alcoholic liver disease, nonalcoholic fatty liver disease and its progressive form NASH, autoimmune hepatitis, and genetic or metabolic disorders such as hemochromatosis and Wilson's disease. Cholestatic diseases such as primary biliary cholangitis and primary sclerosing cholangitis are also within scope. Cirrhosis and its complications, including portal hypertension, ascites, variceal bleeding, and hepatic encephalopathy, are central concerns.

Evaluation typically involves medical history and physical examination, laboratory tests (liver enzymes, bilirubin, albumin, INR), viral serologies, and imaging. Noninvasive tests such as elastography and specialized scoring systems assess fibrosis, while liver biopsy may be used when diagnosis remains uncertain or to stage disease.

Management combines disease-specific therapies with supportive care. Antiviral treatments can cure or suppress hepatitis B and C infections; autoimmune conditions are treated with immunosuppression; metabolic liver diseases require targeted therapy and lifestyle changes. Complications from cirrhosis are managed with ascites control, treatment of variceal bleeding, and prevention of encephalopathy. In eligible patients, liver transplantation offers a curative option.

Hepatology training typically follows internal medicine residency with a fellowship in gastroenterology and a sub-specialty in hepatology. Practice is evidence-based and often involves collaboration with radiology, pathology, and transplant teams. Ongoing research in fibrosis assessment, hepatocellular carcinoma therapy, antiviral regimens, and regenerative approaches shapes the field.