Open AccessLiver involvement in inflammatory bowel disease: What should the clinician know?
Author(s) -
Giuseppe Losurdo,
Irene Vita Brescia,
Chiara Lillo,
Martino Mezzapesa,
M. Barone,
Mariabeatrice Principi,
Enzo Ierardi,
Alfredo Di Leo,
Maria Rendina
Publication year - 2021
Publication title -
world journal of hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.913
H-Index - 55
ISSN - 1948-5182
DOI - 10.4254/wjh.v13.i11.1534
Subject(s) - medicine , inflammatory bowel disease , primary sclerosing cholangitis , context (archaeology) , autoimmune hepatitis , viral hepatitis , fatty liver , cirrhosis , population , disease , gastroenterology , liver disease , hepatitis , immunology , paleontology , environmental health , biology
Inflammatory bowel disease (IBD) may show a wide range of extraintestinal manifestations. In this context, liver involvement is a focal point for both an adequate management of the disease and its prognosis, due to possible serious comorbidity. The association between IBD and primary sclerosing cholangitis is the most known example. This association is relevant because it implies an increased risk of both colorectal cancer and cholangiocarcinoma. Additionally, drugs such as thiopurines or biologic agents can cause drug-induced liver damage; therefore, this event should be considered when planning IBD treatment. Additionally, particular consideration should be given to the evidence that IBD patients may have concomitant chronic viral hepatitis, such as hepatitis B and hepatitis C. Chronic immunosuppressive regimens may cause a hepatitis flare or reactivation of a healthy carrier state, therefore careful monitoring of these patients is necessary. Finally, the spread of obesity has involved even IBD patients, thus increasing the risk of non-alcoholic fatty liver disease, which has already proven to be more common in IBD patients than in the non-IBD population. This phenomenon is considered an emerging issue, as it will become the leading cause of liver cirrhosis.