A hepatologist specialises in diseases of the liver, gallbladder and bile ducts. You may be referred to one if blood tests or imaging suggest a liver abnormality, or if you have a known liver condition requiring specialist management. Consultation may also be appropriate for persistent abnormal liver enzymes, viral hepatitis, fatty liver disease, cirrhosis or unexplained liver-related symptoms. People with advanced or complex liver disease may benefit from ongoing hepatology care to monitor disease progression and manage complications.

Hepatologists manage a broad range of liver and biliary conditions. These include viral hepatitis, metabolic dysfunction-associated steatotic liver disease (MASLD), alcohol-associated liver disease, cirrhosis and its complications, autoimmune liver diseases and certain inherited liver disorders. They also evaluate problems affecting the bile ducts and gallbladder and manage patients with advanced liver disease. Depending on the condition, treatment may involve lifestyle changes, medicines, procedures, monitoring or referral for specialised care such as liver transplantation.

Evaluation usually begins with blood tests that assess liver enzymes, bilirubin and other markers of liver function and overall health. Depending on the suspected condition, doctors may also recommend tests for viral hepatitis, autoimmune disorders or inherited conditions. Imaging such as ultrasound, CT or MRI can assess the liver's structure and identify abnormalities. Elastography may be used to assess liver stiffness and fibrosis. In selected cases, a liver biopsy may be performed to examine liver tissue and clarify the diagnosis or extent of disease.

Treatment depends on the underlying cause, the extent of liver damage and whether complications are present. Management may include lifestyle changes, weight management, avoiding alcohol when advised, and medicines to treat the specific liver condition or its complications. Some forms of viral hepatitis can be treated with antiviral medicines, while autoimmune liver diseases may require medicines that modify the immune response. Regular monitoring is also important. In advanced liver disease, specialised procedures or liver transplantation may be considered.

Not all liver diseases can be prevented, but several measures can lower risk and help protect liver health. Maintaining a healthy weight, eating a balanced diet, staying physically active and limiting or avoiding alcohol can be important, depending on individual circumstances. Preventing viral hepatitis through appropriate vaccination and other preventive measures can also reduce risk. Avoiding unnecessary medicines or supplements that may harm the liver and managing conditions such as diabetes and high cholesterol can further support liver health. People with existing liver disease should follow their specialist's recommendations.

Liver transplant evaluation may be considered when liver disease has progressed to the point that the liver can no longer adequately perform its essential functions, or when certain liver cancers or other severe liver conditions meet transplant criteria. Signs of advanced disease can include complications such as significant fluid accumulation, bleeding related to portal hypertension, confusion from hepatic encephalopathy or worsening liver function. Transplant decisions are complex and depend on the underlying disease, severity, overall health and suitability for transplantation. Early specialist referral can help determine when evaluation should begin.