Gastroenterologist vs. Hepatologist

[sunshine007]

I was recently diagnosed with Hep C.  I did my liver biopsy last week which came back stage 2/4 and grade 2/3 stating I have mild to moderate liver damage. I believe I've had it about 20 years.  I have been referred over to a gastroenterologist for treatment options.  I am wondering if I need to see a hepatologist instead.  I am wondering if there are some dietary things I should do now to help my damaged liver, and if there's anything I should do to help myself prepare for starting treatment.  Thanks for your help.

[sunshine007]

Boy I wish I could just not deal with all of this. It really stinks any of us have to go through this.  I will do whatever it takes to hopefully kill this stupid virus, but I have sneaky suspicion it won't be easy. I have an appt. with another gastro 9/6.  He only treats Hep C patients and I'm anxious to see what genotype I am.  I feel pretty good, but if I get too tired I get really foggy where I can't remember anything.  I have support from my husband, but with three small kids and finances being what they are, he can't do everything unfortunately.  We recently relocated so I don't have a huge network of friends yet and that's one reason this website really means so much to me.  I'll be honest, I don't undersand everything that is being said here, but I guess that's due to being a newcomer.  I look forward to getting to know you all much better.  Wish it could be under different circumstances.  Best Regards!

[FlGuy]

In the US geno 1 is more prevalent than genos 2 and 3.  Geno 1 has abot 70% of the market and the treatment (tx) is 48 weeks with a success rate of about 50%.  Geno 2 and 3 have pretty much the rest of the market and both tx for 24 weeks with success rates in the 70-80% (or higher) though docs are starting to look at geno 3 like they do geno 1.  TX can be rugged and with young kids you'll likely require support from your spouse/friends/family.  If you have geno 2 think of it as good news.  The drugs are nasty and have the potential to be draining on your energy, patience and psyche. A decision to be made with full information and understading.  I tx'd for 24 and didn't miss any work, but had great support on the homefront.  NY is a single mom who just passed 48 weeks, going to 72.  She can check in with addtl info. and suggestions.  A wise decision could be to wait for treatment, depending on many conditions. Don't rush to a decision - information and planning are very important to you now.

[sunshine007]

Thank you guys for being very helpful to me.  I means a whole bunch to have people that understand and care about what I'm going through!  I don't know what genotype I am.  Is one more common than the others?  I believe that I've read that type 1 doesn't respond to treatment as well as 2 & 3.  Is this true?  Also, thank you GrandOak for the websites.  I haven't had a chance to go through them, but I will.  I have a question for nygirl - you said treatment is doable.  Are you able to work while on treatment.  I have three small children, work full + time.  Can treatment be managed and can you still continue to work.  What are some things to take to calm the side effects?  Thanks again for your information - I really do appreciate it!

[NYgirl]

You are about the same grade/stage/time as me.  I have two genotypes though (1A and also 1B). I originally signed up to do 48 weeks but am now doing 72.  It IS doable and I would advise you to learn as much as you can and keep asking questions!  That is the best thing you can do for yourself!

My "regular" doctor is a GI and he has been marvelous.  But...it is important to know that as a patient, it's important for YOU to be knowledgable so that you know what signs to alert your doctor too. If you don't, he can't treat them.  It's a VERY 50/50 type thing and it is a real responsibility that we have.

I went to a world reknown doctor (Heptologist) for a second opinion recently (to discuss my desire to continue on treatment for an additional 6 months) and he said that my GI had done a marvelous job of treating me.

So if you feel you aren't ever sure...there is no reason you can't get another doctor to pipe up and give a second opinion on your treatmaent.

Just remember - it's something YOU have to do as well so learn, learn, learn and that will be your BIGGEST help.

[mycoldfeet]

Shouldn't be hepatolagist VS gastrinterologists I have both, and in fact my gasto studied and worked at Ochsners Hospital one of the leading liver transplant and treatment centers, A good Gasto knows what is liver related and what is not, He fought the insurance Co to get me 72 wks of meds, instead of the 48,(I relapsed) the two types of Dr.s should go together and mine does, They put all their experience together and come up with a plan suited for me. Their expertise is very close to each other as specialists and trust both of them to do what is in my best interest.

[jmjm530]

While there are some excellent gastroenterologists, in general hepatologists (liver specialists) have more training and experience in regard to treating hepatitis c, not to mention the fact that it's easier to spell their name :)

This beocmes very important not only in guiding you with the intial decisions but in how treatment is managed. You might also want to look at the thread above yours, "HCV Tx Decision", for more information.

All the best.

-- Jim

[mycoldfeet]

Isee you've had the alien anal probe also, mine went down both ends, Hope he didn't use the same one, gonna check that billing sheet. Good news is he found something on both ends that wasn't supposed to be there and removed them, spare parts I guess, But I am surprised at the knowledge he has on Hep and all the new drugs, what phase trial thet are in, Can't say a bad thing about him.

[FlGuy]

You're right. I've recently been plumbed at both ends recently and this time, with no new discoveries.  But I've learned, through family sadness, that it's a necessary event.  Doesn't make it any more pleasant, but ya gotta do what ya gotta do.  Just got to 'cowboy up' once in a while.  The prep is worse than the event.

[FlGuy]

To me the distinction between a hepatologist and a gastroenterologist is clear.  The hepatologist will carefully review previous medical information and make a clear and consice recommendations as to how to proceed next.  A gastroenterologist is a fellow who suggests that he shove someting up my butt.

[GrandOak]

Like Beagle, I'm sorry to hear you've joined this sorority of heppers.  Likewise, I echo his comments on the help you should find here from others who are considering treatment, going through treatment, completed treatment, etc..

A good place I've found to start learning more about this insideous disease and how it is treated is:

http://digestive.niddk.nih.gov/ddiseases/pubs/chronichepc/index.htm

and a good one for understanding more about blood labs and how they're used  go to:

http://www.labtestsonline.org/understanding/analytes/cbc/glance.html

for understanding viral loads:

http://www.hepatitis-central.com/hcv/hepatitis/loadchart.html

for new treatments being researched and where they are at:

http://www.hcvdrugs.com/

Hope these links help as starters and do not be afraid to ask, vent, or express concerns at anytime.

As with all information on the Net these days, I would advise you to consider all with a bit of wary skepticism due to the amount of mis-information and down right wrong information one may encounter.  Most of the folks here are pretty good of providing sources for references to information they provide, if not immediately at least when asked.

[Mister beagle bailey]

Sorry to hear you have hep C but just know your not alone.  There are know drs. here but your'll find much help and great people.  If not for the people here, I never would have been able to complete treatment.
A gastroenterologist or hepatologist are both fine to use, my dr was a gastro that speacialized in hep C.
If you drink, you should stop.  Try to eat well and get plenty of sleep to build your body up and ready for treatment.

Do you know what geno type you are?  Do you know your viral load?

Beagle