One liver condition associated with IBD is primary sclerosing cholangitis (PSC). This is a disease of the bile ducts that carry bile from your liver to your small intestine. Inflammation causes scars in the bile ducts, making them hard and narrow. PSC can cause liver failure, repeated infections, and tumours of the bile duct or liver.
Only 5% of patients with ulcerative colitis will develop PSC; however, about 70% of patients with PSC have underlying IBD, usually ulcerative colitis.
PSC is often diagnosed on routine blood tests before symptoms appear. IBD patients should be screened for PSC every year with liver function tests, regardless of whether or not they have symptoms.
There is a high risk of cancer in people who have both PSC and IBD.
Management of PSC involves treating the symptoms and doing procedures to temporarily open the blocked bile ducts.
A liver transplant is the only known cure for advanced PSC. In patients who receive a transplant, there is still a small chance the PSC will recur.
IBD patients diagnosed with PSC should be screened for colorectal cancer and hepatobiliary malignancy (cancer of the liver and bile duct).