Question

Are there any hepatobiliary manifestations in Inflammatory Bowel disease? What are they?

Answer 1

There are hepatobiliary manifestations of inflammatory bowel disease (IBD). People with IBD are at increased risk of hepatobiliary complications. Primary sclerosing cholangitis (PSC) is the most clinically significant of these. Other complications include fatty liver, liver abscess, granulomatous hepatitis, gallstones, hepatic amyloidosis, primary biliary cirrhosis, portal vein thrombosis, reactivation chronic viral hepatitis, drug-induced hepatotoxicity etc. These manifestations can be divided into 3 groups; those that are seen in association with IBD, those that are due to metabolic and physiologic changes induced by the IBD, and those that are secondary to the drugs used in the treatment of IBD. There is no approved treatment for PSC, which is the most clinically significant manifestation, and about 50% of the patients will need liver transplantation within 10-15 years from the time of diagnosis. The drugs used to treat IBD like thiopurines and methotrexate causes drug-induced hepatotoxicity.