? about doctor specialties

Nurses General Nursing

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Do GI doctors treat pt's who have cirrhosis of the liver? I am a new nurse and last night I had a pt who's ammonia level came back critical @ 92. The day before it was critical at 80 and they started him on lactulose. When I called the pcp in the am to let him know, he wasn't extremely concerned b/c it was already critical, and we were already treating it. BUT he said that the GI doctor was taking care of that and that they would be making their rounds later. I was somewhat surprised.... GI doctors treat cirrhosis patients? I just never knew that. I guess it makes sense. Is it common? Thanks again!

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The liver is part of the GI system...

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Specializes in Travel Nursing, ICU, tele, etc.

[color=#ff9933]the gastroenterologist

a gastroenterologist is an internist who has completed specialty training in the treatment of digestive disorders. digestive disorders include disorders of the esophagus, stomach, small and large intestines, pancreas, gallbladder, and liver. in order to become board certified in gastroenterology, the doctor must first become board certified in internal medicine. in order to become eligible to even take the examination for board certification in gastroenterology, a gastrointestinal (gi) fellowship lasting an additional two to three years beyond an internal medicine residency must be completed.

during the course of their two to three years of training in gastroenterology, some gastroenterologists have little exposure to patients with liver disease.

[color=#ff3399]the hepatologist

a hepatologist is the most experienced and qualified type of doctor to treat people with liver disease. since there is currently no separate board certification examination in the field of hepatology, there is no official definition of a hepatologist. however, there are specialized training programs for doctors who are focused solely on liver disease. these are known as hepatology fellowships and typically last from one to two years.

a physician who successfully completes a hepatology fellowship is considered a hepatologist. most hepatologists, although not all, are also gastroenterologists. these doctors have successfully completed both a hepatology and a gastroenterology fellowship.

good question, i was wondering about that myself, why there aren't official liver doctors...it is such a complex organ. this sort of answers the question...;)

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the liver is part of the gi system...

lmao!!! i feel like such a dummmy!! :trout:

thanks for explaining in such simple terms. lol!!!

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Do GI doctors treat pt's who have cirrhosis of the liver? I am a new nurse and last night I had a pt who's ammonia level came back critical @ 92. The day before it was critical at 80 and they started him on lactulose. When I called the pcp in the am to let him know, he wasn't extremely concerned b/c it was already critical, and we were already treating it. BUT he said that the GI doctor was taking care of that and that they would be making their rounds later. I was somewhat surprised.... GI doctors treat cirrhosis patients? I just never knew that. I guess it makes sense. Is it common? Thanks again!

I dont blame you for contacting the Primary care, every place is different. Where I work the primary would handle these values. Now if you are at a teaching hospital then GI would be handling this case. Some providers are not as aggressive on the ammonia as long as the pt is asymptomatic.

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The answer is that it depends on the institution. Most places dont have hepatologists on staff. Those guys are extremely highly trained people found only at major academic medical centers. Community hospitals dont have them.

At big academic hospitals you might have hepatologists that do consults and see patients on the wards, but in community hospitals no hepatologists are available for GI doctors handle those patients.

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