Patients With Ulcerative Colitis and Primary Sclerosing Cholangitis Frequently Have Subclinical Inflammation in the Proximal Colon

Abstract

Patients with UC and PSC who are in clinical remission are significantly more likely to have endoscopic and histologic inflammation in the right colon than patients with UC without PSC. Our findings provide insight into cause of colorectal cancer in UC patients with PSC.

The impact of ileal pouch‐anal anastomosis on graft survival following liver transplantation for primary sclerosing cholangitis

“…As patients with PSC and IPAA often develop pouchitis and poorer pouch function, it is plausible that persistent or recurrent episodes of intestinal inflammation also contribute to an elevated risk of thrombotic injury, akin to that when the colon is retained . Although speculative, evidence to support this hypothesis includes the fact that our ileostomy group experienced the lowest incidence of hepatic artery thrombosis; in addition to findings that show persistent subclinical intestinal inflammation in PSC associated colitis, associations between pouchitis and thrombocytosis, and heightened platelet activation during active IBD…”

Specific Features of Patients With Inflammatory Bowel Disease and Primary Sclerosing Cholangitis

“…Also, the number of hospitalizations and courses of steroids because of UC activity seem to be greater in patients with UC alone compared to those with UC-PSC [35]. A recent retrospective study compared UC patients with and without coexisting PSC who were in clinical remission, and showed that patients with UC and PSC had a significantly greater subclinical endoscopic (odds ratio (OR), 4.21) and histologic activity (OR, 5.13) in the right colon [36]. It is noteworthy that UC-PSC presents a unique phenotype even in the pediatric population.…”

Oral vancomycin in the treatment of primary sclerosing cholangitis-associated pouchitis

“…Ilealpouch patients with concurrent PSC often have diffusepouch as well as afferentlimb inflammation. Similar to PSC-UC [ 5 ], PSC-pouchitis/enteritis may present a distinct phenotype of the immune-mediated disorder. Concurrent chronic pouchitis and PSC have been treated with vedolizumab [ 6 ] and oral budesonide [ 3 ], with symptomatic and endoscopic improvement in pouchitis in the absence of response in liver-function tests.…”