Núñez F P, Castro F, Mezzano G, Quera R, Diaz D, Castro L. Hepatobiliary manifestations in inflammatory bowel disease: A practical approach. World J Hepatol 2022; 14(2): 319-337 [PMID: 35317174 DOI: 10.4254/wjh.v14.i2.319]
Corresponding Author of This Article
Paulina Núñez F, MD, Adjunct Professor, Universidad de los Andes, Inflammatory Bowel Disease Program, Digestive disease center, Avda Plaza 2501, Santiago 7600976, RM, Chile. paulinanunez@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Feb 27, 2022; 14(2): 319-337 Published online Feb 27, 2022. doi: 10.4254/wjh.v14.i2.319
Hepatobiliary manifestations in inflammatory bowel disease: A practical approach
Paulina Núñez F, Fabiola Castro, Gabriel Mezzano, Rodrigo Quera, Diego Diaz, Lorena Castro
Paulina Núñez F, Rodrigo Quera, Universidad de los Andes,Inflammatory Bowel Disease Program, Digestive Disease Center, Santiago 7600976, RM, Chile
Paulina Núñez F, Inflammatory Bowel Disease Program, Hospital San Juan de Dios, Universidad de Chile, Santiago 7701230, RM, Chile
Fabiola Castro, Gabriel Mezzano, Lorena Castro, Universidad de los Andes,Hepatology Program, Digestive Disease Center, Santiago 7600976, RM, Chile
Gabriel Mezzano, Department of Gastroenterology, Hospital del Salvador/Universidad de Chile, Santiago 7600976, RM, Chile
Diego Diaz, Medicine, Universidad de los Andes, Santiago 770976, RM, Chile
Author contributions: All authors equally contributed to this review with the conception and design of the study, literature review and analysis, drafting and critical revision and editing, and approval of the final version.
Conflict-of-interest statement: Quera R and Nuñez FP, have received fees for serving as a speaker for Janssen, Castro F, Mezzano G, Diaz D and Castro L had no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Paulina Núñez F, MD, Adjunct Professor, Universidad de los Andes, Inflammatory Bowel Disease Program, Digestive disease center, Avda Plaza 2501, Santiago 7600976, RM, Chile. paulinanunez@gmail.com
Received: June 18, 2021 Peer-review started: June 18, 2021 First decision: August 18, 2021 Revised: September 10, 2021 Accepted: January 27, 2022 Article in press: January 27, 2022 Published online: February 27, 2022
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.
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.
