Hepatobiliary Alterations in Ulcerative Colitis: A Report from a Tertiary Care Centre in Odisha

Abstract

Background and Aim: Hepatobiliary manifestations are amongst the most common extraintestinal manifestations in chronic ulcerative colitis patients. There is paucity of data on hepatobiliary alterations in ulcerative colitis patients from India. The study was carried out to evaluate the hepatobiliary alterations in ulcerative colitis patients admitted to a tertiary care centre in Odisha. Methods: Consecutive patients 0f ulcerative colitis admitted to Gastroenterology Department S C B Medical College, Cuttack from 0ctober 2013 to April 2015 were included in the study. Patients with history of liver diseases were excluded. All patients were subjected to clinical examination, liver function tests and ultrasonography for evaluation of hepatobiliary alterations. Magnetic resonance cholangiopancreatography (MRCP) was performed in selected patients. Controls were recruited from healthy subjects (n=50). Results: A total of 50 patients [28 (56 %) male; 22 (44 %) female] with ulcerative colitis were included. The mean age and BMI were 42.2±14.1 years and 20.5±4.2 kg/m2 respectively. Patients with mild, moderate and severe disease activity were 12 (24 %), 30 (60 %) and 8 (16 %) respectively. The mean duration of illness was 31.2±31.3 months. Eighteen (36 %) patients had arthralgia, 5 (10 %) had episcleritis, 1 (2 %) had erythema nodosum, 1 (2 %) had pyoderma gangrenosum. One (2 %) had jaundice, pruritus and clay coloured stool in whom MRCP revealed primary sclerosing cholangitis. Eight (16 %) had hepatic steatosis, 9 (18 %) had asymptomatic transaminitis, 6 (12 %) had elevated alkaline phosphatase and 30 (60 %) had hypoalbuminmia. In control groups 14 (28 %) had hepatic steatosis, 14 (28 %) had transaminitis, 8 (16 %) had elevated alkaline phosphatase. Conclusion: The study revealed that hepatobiliary alterations are less common in ulcerative colitis patients except elevated alkaline phosphatase. Arthralgia is the most common extraintestinal manifestations in ulcerative colitis.