Primary sclerosing cholangitis and inflammatory bowel disease comorbidity: An update of the evidence

Andrew Mertz*, Nhu An Nguyen, Konstantinos H. Katsanos, Ryan M. Kwok

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

64 Scopus citations


Comorbid primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD) represent a unique disease phenotype with a different risk profile than PSC or IBD alone. While the pathogenetic mechanisms behind both diseases remain unclear, recent studies have targeted several immune-mediated pathways in an attempt to find a potential therapeutic target. Patients with PSC-associated IBD typically exhibit pancolitis with a right-to-left intestinal inflammatory gradient associated with a greater incidence of backwash ileitis and rectal sparing. Although there is an increased incidence of pancolitis in this population, bowel symptoms tend to be less significant than in IBD alone. Likewise, the degree of inflammation and symptoms of PSC-associated IBD are characteristically less clinically significant. Despite the relatively quiescent clinical presentation of PSC-associated IBD, there is an increased risk for colorectal and hepatobiliary malignancy making vigilance for malignancy essential.

Original languageEnglish
Pages (from-to)124-133
Number of pages10
JournalAnnals of Gastroenterology
Issue number2
StatePublished - 1 Mar 2019
Externally publishedYes


  • Crohndisease
  • Inflammatory bowel disease
  • Primary sclerosing cholangitis
  • Ulcerative colitis


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