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PBC Foundation
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Gastro vs Hepatologist

I have been thinking about this for some time and have a few things I’d like to say. This is supposed to be a support group. I have noticed for as long as I haven a member here, some of the new members are frightened & lost and are desperate for support. I see a lot of support but I also see a selected few who become medical experts. Too many times I have seen “you need to see a hepatologist “, or “gastro drs only specialize in colon, etc. . I for one, see a gastro. He is specialized in gastro, Hepatology & endoscopy. He is in the Liver Clinic at one of our major hospitals. Drs in that clinic specialize in acute & chronic liver disorders. He treats Cirrhosis & complications: portal hypertension, esophageal/gastric varices, acites & hepatic encephalopathy, plus 15 other liver conditions. So, before any one of you feel your hepatologist is the only Dr who specializes in the liver, think before you slam a gastro. And thank all of you who are so kind & helpful.

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Gwillistexas,

I hope nothing I've posted came off sounding dogmatic. Most everything I post is off of WebMD. I simply cut and paste that information in to my reply to someone's question.

I myself see a GI. She in turn referred me to a hepatologist (who by definition is a doctor who went to school and chose "added" courses in a specialized field..i e. Hepatology) That's not to say your GI, or mine for that matter isn't knowledgeable about PBC and how to treat it.

My GI told me she was referring me to a hepatologist (Dr. Joe Olsen) because this was his area of "expertise" and this is what he deals with day in and day out.

So I continue to be monitored by my GI. I have labs done with her and my ultrasounds are also by her. She faxes everything over to Dr. Olsen. However, once a year I'm to see Dr. Olsen. My 2nd appt. with him is at the end of March.

But also, there have been a few times on this forum where I've read that someone was unhappy with their GI. They complained that they felt like they weren't being cared for correctly. As if to insinuate that their GI didn't know much about PBC. Unfortunately It's true, not all GI's are created equal. In this case I probably did pipe in and tell them to see a hepatologist. No doubt others did too.

As for me, especially when I was first diagnosed, confused and scared, I appreciated all the posts I could read. I found that I learned so much more reading everything and everyone's story and advice. In the end, I still ran everything by my doctors. Both my GI as well as my hepatologist. It really helped me to be better equipped to make decisions on the course of treatment they recommended too.

Stella ❤

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Well said

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I go to GI. She's been my gastro doctor for 13 years. She monitors me and I don't feel that I need a hepatologist at this point. In the beginning, I thought I needed one, but, time showed that I'm fine in the care of my GI.

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I echo the thoughts of Ktltel who I find as usual has hit the nail on the head.

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Thank you. Stella is great!

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Because I felt so unwell, and my GP said my symptoms were due to Pbc, I insisted on seeing a hepatologist as they are very specialised in liver conditions. However it has now been established that I also have Coeliac disease and my worst symptoms were due to this. As I feel so much better now I am gluten free, I recently agreed to be under the GI for both Pbc and coeliac. I am happy to stay this way unless my Pbc worsens. I hope this helps. Diane 😊

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Yes & I understand & appreciate that. I have seen that a few come here & feel they’re not getting proper answers or treatment from their GI. In that situation I understand people try to help & suggest seeing a different dr, but the problem that brought me to my post, is there are a very few who are so “authoritative “ about who someone needs to see. And honestly, we are all adults & should know when to see another dr without advice from someone else. If I’m not happy with my GI, I certainly have enough knowledge to know I need to do something without asking. Thank you & hope you do well😊

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I also see a gastro Dr with the Cleve. Clinic for my PBC and he is excellent!

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Mine is too😊

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IN MEXICO IN ORDER TO BE AN HEPATOLOGIST YOU NEED TO BE A GASTRO FIRST. SO THEY MAY HAVE A LOT OF FELLOW OR SPECIALIST AND ITS OK. SO I TO HAVE TO SAY THAT MY DOCTOR IS GASTRO, HEPATOLIST AND ENDOSCOPIST. I AGREE WITH YOU GWILLISTEXAS

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Thank you! Mine did fellowship in Texas & Canada.

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Hi

In my opinion, (my opinion only) For me- the most important criteria when choosing a Dr. (regardless of GI or Hepatologist credential) are:

-- knowledge of most current dx and treatment protocols of PBC ( and/or desire to continue education regarding PBC)

-- availability via email communications, ability to get an appointment (before I have 2 birthdays 😬)

-- willingness to listen to me as someone WITH the disease and to take seriously my concerns, questions, side effects I report etc.

-- willingness to say "I don't know" if that is the case-- instead of getting defensive etc..

-- ability to treat serious conditions that may occur if my disease progresses (or ability to easily get me to someone who CAN)

-- and just on a "personal" level- I love drs. that are "encouragers". A little bit of "you go girl" from my dr. goes a long way sometimes.

We each must find the path that works best for us-- whether it is which drs we choose, or diet we follow or whatever else comes up-

As this site is peer support- I understand and respect that sometimes people feel strongly about "the way to go". When we have a chronic illness we want to believe that we are doing everything "right" to help ourselves... and as humans we want others to confirm that..

But, yes.. we also have to consider sources and make peace with our own decisions. No one else can decide for us.

I wish US all strength and courage and support in the journey. Love to All !

Eileen

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Thank you Eileen. I agree with you 100%❣️

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I too see only a gastro. We don't have access to a local heptologist. He is such a lovely & knowledgeable man & I feel so lucky. I am perfectly happy with him at the moment. Should I worsen I know I may need to see another person such as a heptologist. But why bother them at this stage when a gastro is watching over me like a guardian angel. X

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G’morning. My situation is the same. My GI only sends his patients to 2 very large hospitals in Dallas should I progress to needing a strictly hepatologist. I am impressed with the fact he bypasses the hepatologist here in my city. I too feel confident with his care. Thank you. 😊

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My gastro dr. Dx me with stage one in 2015. He himself recommend me to a specialist in Denver. She pulled the slides from my biopsy and read them quite differently and 900.00 dollars later, i found i am in satge two, not one. Somerimes regaurdless if you think ur dr. Is catching everything , it dosent hurt to have an second pair of eyes to look at ur situation. I think people who suggest these thing u say have experience them, so try hard not to judge, they are only trying to help. Thank you.

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I understand what you’re saying & by no means was I judging anyone. You have to remember it’s not always what you’re trying to say, but words can come across pretty abrupt and nothing smooth about it. Big difference in suggesting & saying “you need” to do something. I have said before & will say again, we are all adults & should know if our dr is not satisfying our needs & take the next step without having to ask someone what to do. If I become unhappy with my dr, I don’t rely on this site to tell me what to do. It’s my health & my priority to myself to move forward.

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True, true...

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My Gastro recommend a Hepatologist at Cleveland Clinic.He is unfamililar with PBC and wanted me to have better care.My Gastro still orders my bloodwork every 4-5 months. I see my Hepatologist every 6 months.

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hi ! i also see a Gastro and im very satisfied and trust him 100%! he also does my endoscopy,colonoscopy etc! !in 2002 i was itching like crazy and went to consult with my skin doctor who did blood work and told me my liver enzyme were very high! big surprise! so ive been with my gastro since and have PBC since about 2002 i retired from work 4 months ago doing fine ,just had my 1st fibroscan in sept F2 light fibrosis 7.8 on Urso from the beginning but lately been itching at nite [change in Urso] but im not complaining

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You are right, gastrointestinal aka gi covers every organs and parts of our digestive system..dr without gastroenterologist can’t be liver specialist which is further specialization on liver related diseases..

My all dr are gi drs with specialization on liver related problem

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My GI is as well. I have to appreciate that he may feel he hit a road block with OCA, not sure if it’s working or not. I think that’s what brought hepatologist involvement.

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Im trying to find a good Doctor. Mine is not realy personable. True. Find a doctor you are comfortable with.

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My-Life...I’m praying this new hepatologist will be kind & understanding. If he is as kind as he looks in his picture, I think I’ll be okay. Good luck on your search 😊

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I hope you get that Christmas wish fulfilled!!!

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ninjagirlwebb...that would be awesome! Kinda sad when you’re so excited to meet a dr. But my hopes are that he can do something to help me be at peace for once. 😊

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I understand where you are coming from...it is often hit or miss with doctors. Sometimes you either hit it off or you don’t. It is a tremendous effort to find compassionate & knowledgeable physicians. You want them to really know their stuff but also have an excellent bedside manner. Unfortunately the 2 don’t often go hand in hand.

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I have no doubt he’s packed with knowledge after all I read about him. Time will tell about his bedside manner. 😊

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I googled my doctors to see if patients wrote reviews on them. But I take everything with a grain of salt as well. Some disgruntled patients are just that & even the best doctors will have a few bad reviews.

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This wasn’t patient reviews. This was his credentials. Plus named one of the best drs in Dallas Magazine 2011-2018.

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But you’re right, there may always be someone who gives a bad review.

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I usually ask my favorite doctors for their recommendations. I figure “birds of the same feather flock together.” That was how I found my new pcp after my old one went concierge on me. Also the doctor told me, he would only recommend the best for me even if they are not in his hospital network.

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September 24th they said 60-90 day process so 90 days would hopefully be this month. 🤞🏻

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