Korean J Gastroenterol.  2019 May;73(5):248-259. 10.4166/kjg.2019.73.5.248.

Hepatobiliary Manifestation of Inflammatory Bowel Disease

• Seo KI
• Kang SB

• KMID: 2447594
• DOI: http://doi.org/10.4166/kjg.2019.73.5.248

Abstract

The hepatobiliary system is one of the most common sites of extraintestinal manifestation in patients with inflammatory bowel disease (IBD). The progression of IBD can lead to a primary hepatobiliary manifestation and can occur secondary to multiple drugs or accompanying viral infections. Primary sclerosing cholangitis is the representative hepatobiliary manifestation of IBD, particularly in ulcerative colitis. Although most agents used in the treatment of IBD are potentially hepatotoxic, the risk of serious hepatitis or liver failure is low. The prevalence of HBV and HCV in IBD is similar to the general population, but the clinical concern is HBV reactivation associated with immunosuppressive therapy. Patients undergoing cytotoxic chemotherapy or immunosuppressive therapy with a moderate to high risk of HBV reactivation require prophylactic antiviral therapy. On the other hand, HCV has little risk of reactivation. Patients with IBD are more likely to have nonalcoholic fatty liver disease than the general population and tend to occur at younger ages. IBD and cholelithiasis are closely related, especially in Crohn's disease.

Keyword

Inflammatory bowel diseases; Primary sclerosing cholangitis; Drug induced liver injury; Hepatitis viruses; Cholelithiasis

MeSH Terms

Cholangitis, Sclerosing
Cholelithiasis
Colitis, Ulcerative
Crohn Disease
Drug Therapy
Drug-Induced Liver Injury
Hand
Hepatitis
Hepatitis Viruses
Humans
Inflammatory Bowel Diseases*
Liver Failure
Non-alcoholic Fatty Liver Disease
Prevalence

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