Practical approach to abnormal liver enzymes in patients with inflammatory bowel disease

Inflammatory Bowel Diseases (IBD) are chronic inflammatory conditions that can impact organ systems beyond the gastrointestinal tract. Extraintestinal manifestations (EIMs) of IBDs are common and can occur at any stage of the disease. While EIMS most commonly involve the musculoskeletal system, up to 35% of individuals with IBD exhibit hepatobiliary involvement at some point during the course of their disease, often independently of disease activity. Chronic hepatobiliary diseases are noted in 5% of patients with IBD. These diseases manifest with indicative symptoms, abnormal liver biochemistry tests, or radiological abnormalities. This review provides a comprehensive outline and approach to abnormal liver enzymes in individuals with IBD.