TY - JOUR T1 - Reversal of intestinal failure-associated liver disease (IFALD): emphasis on its multifactorial nature JF - Frontline Gastroenterology JO - Frontline Gastroenterol SP - 114 LP - 117 DO - 10.1136/flgastro-2015-100560 VL - 7 IS - 2 AU - Christian Hvas AU - Kamelia Kodjabashia AU - Emma Nixon AU - Stephen Hayes AU - Kirstine Farrer AU - Arun Abraham AU - Simon Lal Y1 - 2016/04/01 UR - http://fg.bmj.com/content/7/2/114.abstract N2 - Patients with intestinal failure (IF) and home parenteral nutrition commonly develop abnormal liver function tests. The presentations of IF-associated liver disease (IFALD) range from mild cholestasis or steatosis to cirrhosis and decompensated liver disease. We describe the reversal of IFALD in an adult patient with IF secondary to severe Crohn's disease and multiple small bowel resections. The patient developed liver dysfunction and pathology consistent with IFALD. Multiple causal factors were implicated, including nutrition-related factors, catheter sepsis and the use of hepatotoxic medications. Multidisciplinary treatment in a tertiary IF referral centre included aggressive sepsis management, discontinuation of hepatotoxic medications and a reduction of parenteral nutrition dependency through optimisation of enteral nutrition via distal enteral tube feeding. Upon this, liver function tests normalised. ER -