Irritable bowel syndrome, or IBS, affects up to 15 percent of the U.S. population. According to a December 2005 "American Family Physician" review, IBS is defined as "abdominal pain and discomfort with altered bowel habits in the absence of any other mechanical, inflammatory, or biochemical explanation for these symptoms." In other words, IBS causes symptoms that cannot be explained by physical examination, X-ray or laboratory tests. If your liver enzymes are elevated and you have been diagnosed with IBS, you could be suffering from some other condition.
The cause of irritable bowel syndrome is not known. It is characterized by a variety of symptoms that can change over time. Abdominal pain or pressure, bloating, constipation or diarrhea and excessive gas are common complaints among IBS patients. Your symptoms are typically worsened after eating and relieved following a bowel movement. You may have noticed dietary triggers, such as wheat, caffeine or corn, and stress often makes IBS symptoms worse. Your doctor may have told you that these symptoms can overlap with those of other intestinal disorders, such as celiac disease.
Your liver is a powerhouse of metabolic activity. It is responsible for detoxifying potentially harmful compounds in your bloodstream, manufacturing proteins, cholesterol and other complex molecules, processing lipids and carbohydrates and regulating many physiologic processes. Most of these tasks require the help of enzymes that are housed within your liver's cells. Any process that damages your liver – toxins, inflammation, infection or trauma – releases these enzymes into your bloodstream, where they can be measured. On its own, IBS does not cause liver enzyme elevation.
A study published in the May 2011 issue of "Digestive Diseases and Sciences" revealed that the diagnosis of serious bowel disorders, such as celiac disease or Crohn's disease, is sometimes delayed in patients who have already been diagnosed with IBS. Celiac disease is an immune disorder caused by sensitivity to gluten, a protein found in wheat, rye, barley and similar grains. Crohn's disease is an autoimmune disease that causes inflammation in the wall of your gastrointestinal tract. Both disorders can involve your liver and trigger an increase in your liver enzymes.
Irritable bowel syndrome is not a likely cause of elevated liver enzymes. However, IBS frequently mimics other bowel disorders, such as celiac or Crohn's disease, that do contribute to liver enzyme elevation. It is also possible that you are suffering from IBS and another disorder, such as fatty liver disease, or that your liver is being stressed by a medication, virus or alcohol. The coexistence of IBS and elevated liver enzymes merits further investigation. See your physician to discuss your options.
- “American Family Physician”; Treatment of Irritable Bowel Syndrome; S.K. Hadley, S.M. Gaarder; December 2005
- “Digestive Diseases and Sciences”; Prodromal Irritable Bowel Syndrome May Be Responsible for Delays in Diagnosis in Patients Presenting with Unrecognized Crohn’s Disease and Celiac Disease, but not Ulcerative Colitis; S.M. Barratt, et al.; May 2011
- “The American Journal of Gastroenterology”; Persistent Hypertransaminasemia as the Presenting Feature of Celiac Disease; J. González-Abraldes, et al.; April 1999
- “The Merck Manual of Diagnosis and Therapy, 18th Edition: Crohn’s Disease”; Mark H. Beers, M.D., Editor-in-Chief; 2006