Potential Link Between Inflammatory Bowel Disease and Liver Disease Discovered

Inflammatory bowel disease may increase risk of nonalcoholic fatty liver disease.

A new study published by Inflammatory Bowel Diseases found a link between long-term inflammatory bowel disease (IBD) and nonalcoholic fatty liver disease (NAFLD).

The authors focused their research on the potential association between the 2 diseases because patients with IBD, who were traditionally underweight, have increasingly become overweight.

IBD is characterized by chronic inflammation of the digestive tract that leads to severe diarrhea, pain, fatigue, and weight loss. NAFLD is the abnormal accumulation of fat in liver cells due to factors such as obesity, diabetes, and high cholesterol or triglyceride levels. There are typically no symptoms of NAFLD, but patients may experience fatigue, weakness, or weight loss, according to the American Liver Association.

Included in the study were 400 patients placed into groups based on their conditions: IBD/NAFLD, IBD alone, and NAFLD alone. Approximately 13% of patients had both IBD and NAFLD, which was in line with findings from previous studies.

The study showed that patients with IBD who were also diagnosed with NAFLD tended to be older at initial IBD diagnosis and had IBD for more than 20 years. The authors noted that regardless of age, patients with a longer duration of IBD were more likely to develop NAFLD, according to the study.

This population was also discovered to have metabolic risk factors, such as diabetes, hypertension, and high cholesterol; however, patients with both conditions were observed to have less metabolic risk factors than those with NAFLD alone, according to the study.

"Our findings suggest that just having inflammatory bowel disease doesn't prevent you from getting fatty liver disease," Dr Abraham said. "We need to study a broader patient population to not only validate these findings but also determine other factors, such as inflammatory cytokines, that may contribute to the development of fatty liver in the IBD population."

Patients diagnosed with both IBD and NAFLD require aggressive risk factor modifications to prevent adverse outcomes. These patients may be advised to increase activity levels, lose weight, adopt a healthy diet, and treat hyperlipidemia, diabetes, and hypertension, according to the study.

If those risk factors are not modified, patients with NAFLD can progress to fibrosis and cirrhosis. Eventually patients may develop liver failure and hepatocellular carcinoma, requiring them to receive a liver transplant.

Approximately 20% of patients with IBD have developed a liver disease. These findings suggest that there may be underlying factors that link IBD and liver conditions. The authors plan to conduct further research to determine factors that may lead to NAFLD in patients with IBD, the study concluded.