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Review
. 2023;16(3):259-269.
doi: 10.22037/ghfbb.v16i2.2589.

Concurrent inflammatory bowel disease and primary sclerosing cholangitis: a review of pre- and post-transplant outcomes and treatment options

Behzad Hatami  1 , Leila Pasharavesh  1 , Afsaneh Sharifian  2 , Mohammad Reza Zali  1
Affiliations
Review

Concurrent inflammatory bowel disease and primary sclerosing cholangitis: a review of pre- and post-transplant outcomes and treatment options

Behzad Hatami et al. Gastroenterol Hepatol Bed Bench. 2023.

Abstract

Primary Sclerosing Cholangitis (PSC) is a chronic cholestatic liver disease which is associated with Inflammatory Bowel Disease (IBD) in 70% of cases. It seems PSC/IBD is a distinct phenotype that is different from PSC, and IBD alone. Hence, we review the epidemiology, pathogenesis, natural course and management of PSC/IBD before and after LT for PSC. Extensive colitis, rectal sparing, backwash ileitis, and mild symptoms are the characteristics of IBD coexisting with PSC. Moreover, PSC patients with concurrent IBD have higher risk of cholangiocarcinoma, and colorectal neoplasia predominantly in right colon and at younger age. Therefore, it is essential to monitor these individuals continuously. It is interesting to note that the course of IBD (ulcerative colitis) after liver transplantation (LT) for PSC varies greatly, and some patients may develop worsening colitis after LT despite immunosuppressive regimens. As well, management of these patients was discussed in this review.

Keywords: Cholangiocarcinoma; Colorectal neoplasia; Inflammatory bowel disease; Liver transplantation; Primary sclerosing cholangitis.

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Conflict of interest statement

There is no conflict of interest for authors of this article.

Figures

Figure 1
Figure 1
Step-by-step treatment of ulcerative colitis after liver transplantation for PSC
See this image and copyright information in PMC

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