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 25 February 2018

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News

Hepatic manifestations of inflammatory bowel diseases

The latest issue of Liver International reviews the management of hepatic manifestations in inflammatory bowel diseases.

News image

Inflammatory bowel diseases are associated with various hepatobiliary disorders, reported both in Crohn's disease and ulcerative colitis. 

They may occur at any moment in the natural course of the disease. 

Dr Sophie Restellini and colleagues from Switzerland investigated hepatic manifestations of inflammatory bowel diseases.

The team observed that the prevalence of liver dysfunction rises from 3% to 50% accordingly to definitions used in different studies. 

Fatty liver is considered as the most common hepatobiliary complication in inflammatory bowel diseases while primary sclerosing cholangitis is the most specific one. 

The prevalence of liver dysfunction rises from 3% to 50% accordingly to definitions used in different studies
Liver International
Less frequently, inflammatory bowel diseases-associated hepatobiliary disorders include autoimmune hepatitis/ primary sclerosing cholangitis overlap syndrome, IgG4-associated cholangiopathy, primary biliary cholangitis, hepatic amyloidosis, granulomatous hepatitis, cholelithiasis, portal vein thrombosis and liver abscess. 

The researchers report that the spectrum of these manifestations varies according to the type of inflammatory bowel diseases. 

The team note that treatments of inflammatory bowel diseases may cause liver toxicity, although incidence of serious complications remains low. 

However, early diagnosis of drug-induced liver injury is of major importance as it affects future clinical management. 

When facing abnormal liver tests, clinicians should undertake a full diagnostic work-up in order to determine whether the hepatic abnormalities are related to the inflammatory bowel diseases or not. 

Dr Restellini's team concludes, "Management of hepatic manifestations in inflammatory bowel diseases usually involves both hepatologists and gastroenterologists because of the complexity of some situations."

Liver Int 2017: 37(4): 475–489
04 July 2017

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