Hepatologist Versus Gastroenterologist: What's The Difference Between The Liver Specialists?

A 2019 study published in the Journal of Hepatology found that approximately 2 million people worldwide die of liver diseases per year. Half of those deaths are from cirrhosis of the liver and the other half are from hepatocellular carcinoma and viral hepatitis. Cirrhosis is a leading cause of death worldwide. Additionally, around 75 million people globally have been diagnosed with alcohol-use disorders, making them at risk for liver disease.

Navigating the medical world can be extremely confusing, especially when it comes to figuring out which type of specialist you should see. If you've been diagnosed with a condition involving your liver or you're struggling with symptoms of a liver condition – such as fatigue, loss of appetite, dark urine, pale stools, swollen legs and ankles, or itchy, yellow-colored skin — the Mayo Clinic advises that it's important to see a physician. Medical doctors who specialize in treating the liver can help you navigate the best treatment options for your unique health. 

But which type of doctor is the right fit for you? There are two kinds of specialists who are qualified to treat liver diseases: hepatologists and gastroenterologists. Here is what you should know about the difference between these two.

What is a hepatologist?

Hepatologists specialize in diagnosing, treating, and managing issues related to the liver, as well as the pancreas, gallbladder, and bile ducts (per WebMD). A hepatologist can treat conditions associated with the liver, meaning that a hepatologist might be the right specialist if you're experiencing conditions like cirrhosis, hepatitis, liver cancer, and alcohol-induced liver disease. 

After finishing four years of medical school, their advanced training occurs in either a three-year fellowship in gastroenterology followed by an additional year-long fellowship in transplant hepatology, or a three-year post-residency fellowship in joint gastroenterology and transplant hepatology. By receiving training in transplant hepatology, these medical specialists are qualified to treat advanced liver disease and perform liver transplants.

Hepatology is a field that has emerged from gastroenterology. While some gastroenterology departments still house hepatology, the more liver-focused hepatology has begun to make a name for itself as an autonomous specialty with its own subspecialties. According to Doctorly, hepatology is still in the process of establishing itself as an independent medical specialty and since the separation from gastroenterology is still in progress, many post-residency fellowship programs combine hepatology alongside gastroenterology. Hepatology studies are even being incorporated earlier in medical training. A 2021 study published in Hepatology Communications discussed the benefits of giving internal residents specific training in hepatology given the prevalence of chronic liver conditions. Since approximately 1.8% of adults have some form of diagnosed liver condition, the medical field of hepatology is becoming increasingly important.

What is a gastroenterologist?

According to the American College of Gastroenterology, gastroenterologists are able to treat all organs involved in the digestive tract. You can think of your digestive tract as the entire trail your food travels from the time you eat it until you go to the restroom. Gastroenterologists are capable of treating organs including the esophagus, stomach, gallbladder, bile ducts, small intestine, pancreas, colon, and rectum. If you want a specialist who is versed in multiple organs, or if your symptoms spread to other parts of your digestive tract in addition to your liver, then a gastroenterologist may be the right type of doctor to see.

Gastroenterologists receive the same training as hepatologists do; but, after finishing medical school, they must first successfully complete a three-year internal medicine residency followed by a fellowship specifically in gastroenterology that lasts for two to three years, as reported by the American Medical Association (AMA). A 2021 study published in the Journal of Emergency and Internal Medicine further reports that gastroenterologists are frequently trained in advanced interventional and endoscopic methods to diagnose and treat conditions and infections from the mouth to the rectum by way of the entire digestive tract.