Hepatobiliary Manifestation of Inflammatory Bowel Disease

Kwang Il Seo; Sang-Bum Kang

doi:10.4166/kjg.2019.73.5.248

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Seo and Kang: Hepatobiliary Manifestation of Inflammatory Bowel Disease

Special Review

Extraintestinal Manifestations of Inflammatory Bowel Disease

The Korean Journal of Gastroenterology 2019; 73(5): 248-259.

Published online: 27 May 2019

DOI: https://doi.org/10.4166/kjg.2019.73.5.248

Hepatobiliary Manifestation of Inflammatory Bowel Disease

Kwang Il Seo, Sang-Bum Kang¹

Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.

¹Division of Gastroenterology, Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.

Correspondence to: Sang-Bum Kang, Division of Gastroenterology, Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 64 Daeheung-ro, Jung-gu, Daejeon 34943, Korea. Tel: +82-42-220-9501, Fax: +82-42-252-6807, dxandtx@catholic.ac.kr

Received 3 April 2019 Revised 5 May 2019 Accepted 12 May 2019

Korean Society of Gastroenterology

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Inflammatory bowel diseases, Primary sclerosing cholangitis, Drug induced liver injury, Hepatitis viruses, Cholelithiasis

Figures and Tables

Table 1

Hepatobiliary Manifestation in Patients with Inflammatory Bowel Disease

CD, Crohn's disease; UC, ulcerative colitis.

Table 2

Risk of HBV Reactivation according to the Types and Dose of Medication

HBV, hepatitis B virus; TNF-α, tumor necrosis factor-alpha.

Notes

^{Financial support} None.

^{Conflict of interest} None.

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