Hepatobiliary manifestations in inflammatory bowel disease: A practical approach

Abstract

Inflammatory bowel diseases (IBD) are associated with various hepatobiliary disorders. They can occur at any moment in the course of the disease or associated with the treatment. The prevalence of liver dysfunction can reach up to 50% in different studies. Nonalcoholic fatty liver disease is considered the most common hepatobiliary complication in IBD, while primary sclerosing cholangitis is the most specific. Management of hepatic manifestations in IBD involves a multidisciplinary approach that includes a high index of suspicion and joint management with hepatologists. The medical confrontation with abnormal liver tests must include an exhaustive study to determine if these patterns can be related to IBD, associated diseases or to the therapies used.

Keywords: Extraintestinal manifestations; Inflammatory bowel disease; Sclerosing primary cholangitis; Hepatic steatosis; Liver toxicity

Core Tip: Inflammatory bowel diseases are associated with various hepatobiliary disorders. They can occur at any moment in the course of the disease or associated with the treatment. Although hepatic manifestations are known, they are not always searched for in a directed manner. This review article presents the main hepatobiliary manifestations, including those caused by new therapies (biologics and small molecules). Finally, we propose a management algorithm.