Here are five liver-related conditions that can develop alongside IBD.
1. Primary sclerosing cholangitis
Primary sclerosing cholangitis (PSC) is a form of liver disease associated with IBD. This occurs most often with UC, says Donald Jensen, MD, a hepatologist at Rush University Medical Center in Chicago.
According to a systematic review and meta-analysis of 776,700 IBD patients, 2.16% also had PSC.
PSC is characterized by inflammation, thickening, and fibrous tissue formation in the bile ducts, which carry bile from the liver to aid in the digestion of fats. Eventually, liver scarring may develop. Without treatment, people with CFP may eventually need a liver transplant.
“We don’t know why they are linked, and there is no effective treatment for PSC,” says Dr. Jensen.
According to a review article, the link between PSC and IBD points to an emerging concept called the gut-liver axis. In the gut-liver axis, the gut and liver influence each other in a bidirectional relationship.
Men with ulcerative colitis are more likely than women to develop PSC, with a prevalence of approximately 60 to 70 percent. The typical age at diagnosis is between 30 and 40, but it can vary by region.
2. Steatotic liver disease associated with metabolic dysfunction
Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease, is the most common hepatic complication of IBD.
MASLD is a condition in which excess fat is deposited in the liver. People with MASLD rarely have symptoms. In many cases, weight loss and management of blood cholesterol levels and diabetes can reverse the disease.
According to a systematic review and meta-analysis of 89 studies, MASLD occurred in 24.4% of people with IBD. Of these, 20.2 percent occurred in people with Crohn’s disease and 18.5 percent in people with UC.
3. Autoimmune hepatitis
Autoimmune hepatitis occurs when your immune system attacks your own liver cells. It is caused by chronic inflammation of the liver.
There are two main forms of autoimmune hepatitis: type 1 and type 2. Type 1 is the most common form of the disease. About half of people with type 1 also have other autoimmune diseases, such as celiac disease, rheumatoid arthritis, or ulcerative colitis.
Autoimmune hepatitis is usually treated with a high-dose corticosteroid, such as prednisone. The dosage is ultimately reduced.
Sometimes a medicine called azathioprine (Imuran) is used as a second line of treatment. Azathioprine is an immunomodulator, meaning it modifies the activity of the immune system, thereby reducing inflammation.
4. Gallstones
Gallstones form when bile, produced by the liver and stored in the gallbladder, hardens into small, stone-like pieces. If one or more stones block the ducts to the gallbladder, you may experience upper abdominal pain, nausea, and vomiting.
Blockage can lead to serious complications. “When gallstones pass from the gallbladder into the bile ducts, it may be associated with infection or pancreatitis,” says Jensen.
Dr. Raffals notes that ulcerative colitis itself does not lead to gallstones, but that gallstones are common in older patients with IBD. They are also more common in patients with Crohn’s disease than in those with UC.
According to a meta-analysis of five studies, people with IBD had a significantly higher rate of gallstones than the general population. However, most of these cases have occurred in people with Crohn’s disease. The authors note that larger-scale studies are needed to confirm these results.
5. Pancreatitis
Pancreatitis, or inflammation of the pancreas, occurs more often in people with IBD than in the general population.
In most cases, pancreatitis associated with IBD appears to be related to gallstones or medications used to treat IBD. However, some cases may be due to direct damage from this condition. “Pancreatitis and inflammatory bowel disease often present in the same way, so patients can be misdiagnosed,” says Raffals.
Symptoms of pancreatitis may include abdominal pain, vomiting, nausea and diarrhea.
Takeaways
Up to 30 percent of people with inflammatory bowel disease are affected by liver abnormalities.
IBD itself, as well as some medications intended to treat the disease, can cause liver damage.
People with IBD should have their liver enzymes checked at least once a year and be aware of the symptoms of liver disease.
:max_bytes(150000):strip_icc()/Health-GettyImages-1199861252-867e73ff11994a7ea2a7a1dd542d2086.jpg?w=390&resize=390,220&ssl=1 "What happens to your body when you eat yogurt every day")
:max_bytes(150000):strip_icc()/Health-GettyImages-614308964-bd315691572d4b2189c82e47697af3b3.jpg?w=390&resize=390,220&ssl=1 "These 3 tips can help you eat more slowly and support your weight goals")
