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Korean J Gastroenterol  <  Volume 73(5); 2019 <  Articles

Korean J Gastroenterol 2019; 73(5): 248-259  https://doi.org/10.4166/kjg.2019.73.5.248
Hepatobiliary Manifestation of Inflammatory Bowel Disease
Kwang Il Seo and Sang-Bum Kang1
Department of Internal Medicine, Kosin University College of Medicine, Busan; Division of Gastroenterology, Department of Internal Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea1, 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, E-mail: dxandtx@catholic.ac.kr, ORCID: https://orcid.org/0000-0002-1946-7896
Received: April 3, 2019; Revised: May 5, 2019; Accepted: May 12, 2019; Published online: May 25, 2019.
© The Korean Journal of Gastroenterology. All rights reserved.

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


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