Best Hepatologist in Kochi – Dr. Charles Panackel

A gastroenterologist treats the whole digestive tract — oesophagus, stomach, intestines, pancreas, liver. A hepatologist is a gastroenterologist who has sub-specialised in the liver and bile ducts alone, and so sees a far higher volume of complex liver disease. A transplant hepatologist has further training in selecting patients for transplant and managing them medically before and for life afterwards. Dr. Panackel is trained in gastroenterology, with advanced sub-specialty expertise in hepatology and liver transplantation.

Consider a hepatology consultation if you have:

• Abnormal liver function tests (raised SGOT/SGPT, bilirubin or GGT) on a routine health check
• Fatty liver reported on ultrasound — particularly with diabetes, obesity or high triglycerides
• A positive hepatitis B or hepatitis C test, or a family member with hepatitis B
• Jaundice, persistent itching, or dark urine with pale stools
• Known cirrhosis, or any complication such as abdominal swelling, vomiting of blood or confusion
• A liver lesion or mass found on imaging
• Suspected liver injury from medication, bodybuilding supplements or herbal preparations
• A family history of liver disease or liver cancer

His practice covers metabolic dysfunction-associated steatotic liver disease (MASLD/MASH), alcohol-associated liver disease, hepatitis B and C, autoimmune hepatitis, primary biliary cholangitis and primary sclerosing cholangitis, Wilson disease and haemochromatosis, cirrhosis and its complications (ascites, variceal bleeding, hepatic encephalopathy, kidney dysfunction), acute liver failure and acute-on-chronic liver failure, liver cancer, liver disease in pregnancy, and drug- or herb-induced liver injury.

Liver transplant surgery itself is performed by transplant surgeons. As a transplant hepatologist, Dr. Panackel leads the medical side of the programme: deciding who needs a transplant and when, evaluating recipients and living donors, listing and prioritising patients, managing them medically through the perioperative period, and providing lifelong follow-up afterwards — including immunosuppression, infection surveillance and long-term metabolic and kidney health. He has been involved in establishing liver transplant programmes in Kerala.

In large part, yes — but it depends on the stage. Simple fat accumulation in the liver (steatosis) usually clears with sustained weight loss of roughly 7–10% of body weight, regular exercise, better control of diabetes and lipids, and avoidance of alcohol. Once inflammation and scarring (MASH with fibrosis) have set in, improvement is still possible but slower, and requires long-term commitment rather than a short diet. Advanced scarring — cirrhosis — can usually be stabilised but not fully reversed, which is why early assessment matters.

Most early liver disease causes no symptoms at all. It is typically detected through abnormal liver function tests on a routine check-up, or as fatty liver on an ultrasound done for another reason. When symptoms do appear — jaundice, abdominal swelling, swelling of the legs, vomiting of blood, black stools, easy bruising or confusion and drowsiness — they usually indicate advanced disease and need prompt specialist review. Vague fatigue, poor appetite or right-sided abdominal discomfort are non-specific but worth investigating if persistent.

Appointments can be booked through the Appointments page of this website, by phone, or via WhatsApp. Please carry previous liver function tests, ultrasound or CT/MRI reports, biopsy reports, discharge summaries and a current list of all medications, including any herbal or over-the-counter supplements. A prior appointment is recommended.

Dr. Panackel consults at Aster Integrated Liver Care, Aster Medcity, Kochi, Kerala. The unit offers full hepatology and liver transplant services, including hepatology outpatient care, liver intensive care, endoscopy for portal hypertension, and living-donor and deceased-donor liver transplantation.

Yes. Teleconsultation is available on request, in line with India’s Telemedicine Practice Guidelines, and is especially useful for reviewing reports, follow-up of stable liver disease, and post-transplant patients living far from Kochi. Some situations — a first assessment of complex disease, physical examination, or an acute illness — still require an in-person visit, and you will be advised if so.

Keep weight, blood sugar, blood pressure and lipids in the healthy range

• Aim for 150 minutes of moderate exercise a week
• Limit or avoid alcohol; there is no intake that is entirely risk-free for the liver
• Get vaccinated against hepatitis B if you are not already immune, and have your family screened if you are hepatitis B positive
• Be cautious with herbal, Ayurvedic, weight-loss and bodybuilding supplements — herb- and drug-induced liver injury is a common and preventable cause of serious liver damage in Kerala
• Have liver function tests as part of a periodic health check, particularly if you have diabetes or are overweight

No. Alcohol-associated liver disease results from excess alcohol intake. Metabolic dysfunction-associated steatotic liver disease (MASLD), previously called NAFLD, arises from metabolic factors — excess weight, type 2 diabetes, insulin resistance and dyslipidaemia. Current nomenclature also recognises MetALD, where a patient has metabolic risk factors and a significant alcohol intake, which is common in practice. All three can progress to cirrhosis and liver cancer, and each requires a different management emphasis.

Cirrhosis is advanced scarring and is generally not fully reversible, but it is very treatable. When the underlying cause is removed — alcohol stopped, hepatitis B or C treated, weight and diabetes controlled — the liver often stabilises and can partially recover, and complications can be prevented with surveillance. Many people with compensated cirrhosis live normally for years. Transplant is considered only when the liver can no longer sustain function.

There is no threshold that is completely safe, and susceptibility varies widely between individuals — genetics, gender, obesity and diabetes all influence risk. Women develop liver injury at lower intakes than men. Anyone with existing liver disease of any cause, or with hepatitis B or C, should avoid alcohol entirely.

Living donation is carried out only after a detailed medical and psychological evaluation to confirm the donor is healthy and donating voluntarily. The donated portion of liver regenerates over a few months in both donor and recipient. Donation is major surgery and carries real risks, which are discussed openly during evaluation; donor safety takes precedence over every other consideration.

Yes, it should still be assessed. Liver enzymes are often normal even when fibrosis is developing, so normal tests do not rule out significant disease. A simple risk assessment — such as a FIB-4 score or a fibroscan — helps determine whether you need close follow-up or straightforward lifestyle advice.

Anyone with cirrhosis, and many people with chronic hepatitis B even without cirrhosis, should have an ultrasound of the liver every six months, sometimes with an AFP blood test. Liver cancer detected on surveillance is often curable; detected because of symptoms, it usually is not.