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- Title
Concurrent inflammatory bowel disease and primary sclerosing cholangitis: a review of pre- and post-transplant outcomes and treatment options.
- Authors
Hatami, Behzad; Pasharavesh, Leila; Sharifian, Afsaneh; Zali, Mohammad Reza
- 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.
- Subjects
INFLAMMATORY bowel disease treatment; ULCERATIVE colitis; INFLAMMATORY bowel diseases; CHOLANGIOCARCINOMA; AGE distribution; BILE duct diseases; TREATMENT effectiveness; COLORECTAL cancer; LIVER transplantation; IMMUNOSUPPRESSIVE agents; COMORBIDITY; DISEASE risk factors; SYMPTOMS
- Publication
Gastroenterology & Hepatology from Bed to Bench, 2023, Vol 16, Issue 3, p259
- ISSN
2008-2258
- Publication type
Article
- DOI
10.22037/ghfbb.v16i2.2589