Assessing Liver Health and Ulcerative Colitis Connection

Assessing Your Liver Health with Ulcerative Colitis

Ulcerative colitis (UC) is an inflammatory bowel disease that causes long-lasting inflammation and ulcers in the digestive tract. One of the extraintestinal manifestations of UC is liver conditions. There's a particularly close association between the inflammation of UC and certain types of liver disease.

If you have UC, it's important to monitor your liver health regularly. Catching problems early allows for quicker treatment to prevent significant damage. Taking a simple "Is My Liver Healthy" quiz can help alert you to potential issues.

Key Liver Functionality Checks

Start by tuning into key aspects of general liver performance with these quick self-checks:

• - Do you feel abnormally fatigued or weak?
• - Have you noticed changes in sleep habits or quality?
• - Are bowel movements unusually light colored?
• - Have you experienced confusion, forgetfulness or trouble focusing lately?
• - Have you noticed yellowish skin or eyes recently?
• - Do you have itchy skin with no rash present?

If the answer is yes to one or more, it may indicate emerging liver trouble worth getting examined.

Bloodwork Marker Checks

Ask your gastroenterologist to check these specific liver enzymes and proteins during routine bloodwork for additional screening:

• - Alanine aminotransferase (ALT)
• - Aspartate aminotransferase (AST)
• - Alkaline phosphatase (ALP)
• - Albumin
• - Bilirubin

Elevated levels signify inflammation, injury or compromises in cell integrity at varying degrees of severity. Your doctor can interpret the results.

Imaging Test Options

If bloodwork is concerning, your doctor may order imaging tests for further evaluation. These could include:

• - Abdominal ultrasound - uses soundwaves to examine liver appearance
• - CT scan - specialized X-rays to visualize liver structure
• - MRI - radio waves and magnets to construct images of organs
• - MRCP - enhanced MRI visualizing bile and pancreatic ducts
• - Liver biopsy - microscopic sample examination

These tests help identify the type and extent of problems present to plan treatment accordingly.

Primary Liver Conditions Tied to Ulcerative Colitis

Three liver-related conditions most prevalent in people with ulcerative colitis include:

1. Primary Sclerosing Cholangitis (PSC)

This progressive disease causes inflammation, scarring and narrowing of the bile ducts inside and outside the liver. It obstructs bile flow. Prevalence among those with UC ranges widely from 2.4% to 7.5%. PSC may be asymptomatic at first then progress, causing:

• - Jaundice - yellowish eyes/skin
• - Itching - Salt-like crystals deposited in skin
• - Fatigue - Bile trapped in liver instead of aiding digestion
• - Abdominal Pain - Duct inflammation/scarring

PSC requires lifelong monitoring but is manageable during early stages through ursodeoxycholic acid medication paired with surveillance endoscopies to detect changes quickly. More advanced PSC may necessitate draining bile duct blockages surgically or ultimately, liver transplantation.

2. Autoimmune Hepatitis (AIH)

This chronic autoimmune condition provokes inflammation and liver cell damage. AIH prevalence in UC patients is 1.6%. Characteristics include:

• - No obvious cause for liver injury
• - Interface hepatitis seen on biopsies
• - Hypergammaglobulinemia blood marker
• - Presence of telling autoantibodies

First line of defense is immunosuppressant medications azathioprine or 6-MP alongside prednisone tapered over time. Most achieve long-term remission although some require eventual liver transplant if cirrhosis develops.

3. Nonalcoholic Fatty Liver Disease (NAFLD)

This umbrella term defines liver damage similar to alcoholic liver disease occurring in non-drinkers. Specific conditions falling under the NAFLD heading include:

• Nonalcoholic Fatty Liver (NAFL): excess fat stored in liver cells without inflammation/damage
• Nonalcoholic Steatohepatitis (NASH): combines excess fat plus substantial inflammation/injury risking scarring

Prevalence jumps to anywhere from 25-66% in UC patients depending on severity. Main risks include obesity, diabetes/insulin resistance, hypertension or high cholesterol. Losing weight through dietary changes and exercise ideally reverses NAFLD. If not controlled, it can progress to liver failure requiring transplant.

Additional Screening Essentials for UC Patients

Beyond the "Is My Liver Healthy" Quiz and typical laboratory work/imaging tests, be sure to undergo these UC-specific secondary screenings regularly as well to protect long-term wellness:

Colonoscopy/Biopsy

Have a full colonoscopy with random biopsy sampling every 1-2 years checking for:

• - Colorectal Cancer - UC patients at higher risk over time depending on severity and extent of inflammation
• - Dysplasia - Precancerous cell changes often occurring before cancer manifests

Identifying dysplasia allows removal of affected sections before cancer develops. And detecting early stage colorectal cancer drastically improves prognosis.

Osteoporosis Assessment

Longstanding UC raises osteoporosis risk. Measure bone mineral density through DEXA scans periodically. Initiate vitamin D/calcium supplementation alongside osteoporosis treatment if thinning indicated.

Skin Check

Some medications used to treat UC like azathioprine may elevate skin cancer odds. Self-monitor skin markings at home and undergo full body inspection annually by a dermatologist.

Eye Exam

Chronic UC slightly heightens the chance of inflammation inside the eyes. Have an ophthalmologist examine your eyes fully every 1-2 years to analyze for signs of uveitis, redness/pain or changes in vision requiring treatment.

Remember, preserving your long term health with ulcerative colitis means looking beyond your bowels. Protect all aspects of wellness through multidisciplinary care and self-monitoring.

When to Seek Emergency Liver Care

While most liver conditions related to UC progress gradually, allowing for non-urgent medical management, certain alarming symptoms require ER-level care, like:

• - Abdominal swelling/fluid retention
• - Bruising easily or nosebleeds
• - Bloody/tarry stools
• - Vomiting blood
• - High fever unrelieved by medications
• - Jaundice paired with confusion/drowsiness
• - Chest pain - Sign of inflammation around liver (peritonitis)

Racing to the hospital enables rapid treatment of trauma, bleeding, infections or liver failure threatening health or life until stability is restored.

Improving Liver Health Through Lifestyle Factors

While some liver conditions related to colitis rely heavily on medication management, certain lifestyle measures can also improve liver health and inflammation levels. These include:

Nutrition Optimization

Ask your doctor to refer you to an integrative RD nutritionist to analyze current dietary inflammation triggers and advise anti-inflammatory alternatives to promote liver and gut healing. Key considerations:

• - Limit processed sugars and refined carbs
• - Moderate red meats - Choose leaner proteins like fish, poultry, beans
• - Increase colorful fruits/vegetables - Rich in antioxidants
• - Avoid alcohol/minimize certain supplements until liver stable

Attaining/Maintaining Healthy Body Weight

Carrying excess weight strains the liver metabolically and insulin resistance further compounds inflammation. Work toward gradual weight loss through both dietary quality and engaging in regular physical activity.

Incorporating Stress Relief Routines

Chronic stress hormones exacerbate inflammatory conditions systemically. Actively carve out daily relaxation practices like yoga, meditation, nature immersion, massage or counseling sessions.

Establishing Solid Sleep Hygiene Habits

Restorative sleep enables liver enzymes to best perform regenerative and detoxifying overnight. Prioritize consistency with sleep/wake timing and optimize bedroom comfort and darkness.

While some liver health factors live largely outside our control, dedicating focus to these lifestyle elements empowers patients with ulcerative colitis to directly improve the health of this vital organ.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.