AI Summary People with cirrhosis need liver cancer screening with ultrasound and an AFP blood test every 6 months, even after hepatitis C is cured, according to EASL guidelines.
Source: EASL Clinical Practice Guidelines on treatment of hepatitis C, via Aimy Science Knowledge Research (July 27, 2026)
A hepatologist is a doctor who specializes in the liver. Hepatology is the branch of medicine that focuses on the liver, gallbladder, and bile ducts. You may also hear the term liver specialist.
Hepatologists diagnose and manage liver disease. That includes abnormal liver tests, fatty liver disease, hepatitis, cirrhosis, liver cancer, and liver transplant evaluation.
Many people start with a primary care doctor or a gastroenterologist and see a hepatologist when liver disease needs closer attention.
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Overview
A hepatologist is a doctor with advanced training in liver disease. Your liver filters toxins from your blood and does hundreds of other essential jobs. It often shows no symptoms when it is damaged, so liver disease can go unnoticed for years. A hepatologist helps find the problem, find the cause, and slow or stop further damage.
Role
A hepatologist works out what is harming your liver and how far the damage has gone. Chronic liver disease moves through four rough stages: hepatitis (inflammation), fibrosis (scarring), cirrhosis (severe, permanent scarring), and liver failure. Your hepatologist tracks where you are and plans care to protect your liver.
Conditions
This is an overview, not a full list. Your care depends on your diagnosis and how far the condition has progressed.
Hepatologists care for hepatitis A, B, C, D, and E. Hepatitis B is the most common liver infection in the world. Hepatitis C is more likely to become chronic. Viral hepatitis may cause no symptoms at first, so you can have it and spread it without knowing. Treatment can protect your liver from long-term damage.
Metabolic dysfunction-associated steatotic liver disease (MASLD, formerly NAFLD) is fat buildup in the liver linked to conditions such as obesity, type 2 diabetes, high blood pressure, and abnormal blood fats. MASH (formerly NASH) is a serious form in which the fat causes inflammation and scarring. Alcohol-related liver disease comes from heavy alcohol use. Hepatologists find the cause, measure scarring, and guide lifestyle and medical care.
Some liver diseases start in the immune system or the bile ducts. Examples are autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis. Others are inherited, such as Wilson disease, hemochromatosis, alpha-1 antitrypsin deficiency, and Gaucher disease. If a relative has one of these conditions, tell your hepatologist.
Cirrhosis is severe, permanent scarring. Your body may compensate at first, so you might not notice it. Over time, cirrhosis can cause portal hypertension (high pressure in the portal vein), which can enlarge veins that may bleed. It can also cause fluid buildup, confusion from hepatic encephalopathy, and liver failure. Hepatologists treat these complications and watch for liver cancer.
People with cirrhosis have a higher risk of hepatocellular carcinoma, the most common type of primary liver cancer. Hepatologists lead surveillance and work with oncologists, interventional radiologists, and surgeons on treatment. When the liver can no longer keep up, they also evaluate you for a liver transplant.
Diagnosis and care
Your hepatologist picks tests based on your symptoms, history, and risk factors. Many people need only some of these.
Blood tests show how well your liver and kidneys work. They also help find causes such as viral hepatitis and track changes over time. Simple blood-based scores can estimate scarring without a biopsy.
Ultrasound, CT, and MRI show the size and shape of the liver and can find masses. FibroScan is a quick, painless test, usually 5 to 10 minutes. You lie on your back while a small probe rests over your liver. It reports liver stiffness, which reflects scarring, and a CAP score, which reflects liver fat. Abnormal results are a reason for follow-up, not a final diagnosis.
A liver biopsy takes a small tissue sample. Your doctor may suggest one when blood tests or imaging are abnormal, or when you have jaundice or other signs of liver disease. Imaging tests are not as accurate and do not replace a biopsy when one is needed.
If you have cirrhosis, your hepatologist screens for liver cancer with imaging and checks for enlarged veins (varices). Guidelines recommend liver cancer surveillance with imaging every 6 months for people with cirrhosis. Screening endoscopy for varices is advised when cirrhosis is diagnosed. Surveillance continues for life, even after a hepatitis C cure.
Treatment depends on the cause. Hepatologists prescribe or guide antivirals for hepatitis B and C, treatment for fatty liver and alcohol-related liver disease, and therapies for inherited conditions. They can also prescribe medicines for metabolic risk factors such as obesity and diabetes, and involve an endocrinologist for complex cases. For complications, they manage fluid buildup, hepatic encephalopathy, and bleeding risk. They also advise on nutrition and medicines that can hurt your liver.
Hepatologists are part of the team that evaluates you for a liver transplant. The evaluation includes blood tests, imaging, heart and lung tests, and a review by a hepatologist, a transplant surgeon, and other specialists. It can take several days to several weeks. After transplant, your team monitors your liver for life.
A balanced, liver-friendly diet supports your liver, helps manage weight and blood sugar, and lowers the risk of other health problems during long-term follow-up.
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Timing
Your primary care doctor or gastroenterologist may refer you, or you can ask for a visit if you are worried about your liver. Liver disease often causes no symptoms early on, so a routine blood test may be the first clue. If you have symptoms or think you are at risk, make an appointment with your doctor. Only a doctor can tell you what is causing your symptoms.
Urgent care
Routine symptoms call for an appointment. Some signs need care right away, especially if you have cirrhosis. Do not wait for a specialist visit if you have any of these.
Comparison
Liver care often involves a team. Each expert has a different focus, and you may see more than one.
| Specialist | Main Focus | How They Relate to Liver Care |
|---|---|---|
| Hepatologist | The liver, gallbladder, and bile ducts | Leads diagnosis and treatment of liver disease, cirrhosis complications, and liver cancer screening |
| Gastroenterologist | The whole digestive system | Evaluates abnormal liver tests and common liver conditions, and refers you to a hepatologist for advanced or complex disease |
| Endocrinologist | Hormone and metabolism conditions, such as diabetes and thyroid disease | Helps manage conditions linked to fatty liver disease |
| Liver transplant specialists | Evaluation, surgery, and follow-up for liver transplant | Work in a team that includes hepatologists and transplant surgeons |
| Nutritionist | Eating plans built around your health | Helps you follow a liver-friendly diet |
Many people start with a primary care doctor or gastroenterologist and are referred to a hepatologist when liver disease needs more specialized care.
Your visit
Your hepatologist will review your health history, ask about your symptoms, and examine you. They may order blood tests, imaging, or other tests. Ask the office about any food or drink limits before the visit. Bring the items below so your doctor can help you as fully as possible.
Questions
Write your questions down before you go. These ten cover the main topics.
Next steps
Start with your primary care doctor or gastroenterologist, who can refer you. You can also search LiverDirectory below. Before you book, a few questions can help you choose a specialist who fits your needs.
Common questions
A hepatologist focuses on the liver, gallbladder, and bile ducts. A gastroenterologist treats the whole digestive system, which includes the liver. Either can start your evaluation. If your liver disease is advanced or complex, a hepatologist usually leads your care. Learn more on our gastroenterologists page.
Not always. You can see a hepatologist on your own if you are worried about your liver. Some practices and insurance plans ask for a referral, so check with the office before you book.
Hepatologists treat viral hepatitis, fatty liver disease, alcohol-related liver disease, autoimmune and inherited liver diseases, cirrhosis and its complications, and liver cancer. They also evaluate people for a liver transplant.
Not always. Simple blood-based scores are a common first step to estimate scarring, and a FibroScan can confirm the result. A biopsy is used when noninvasive tests are unclear. Your hepatologist decides which tests fit your situation.
Yes. Hepatologists care for fatty liver disease, and they can prescribe medicines for related conditions such as obesity and diabetes. For complex diabetes care, they may work with an endocrinologist. Diet and exercise are also key parts of treatment.
Medical disclaimer: LiverDirectory provides educational information and a directory of providers. It does not provide medical advice, diagnosis, or treatment. Always consult a licensed physician regarding any medical condition.
