Additional Problems

Additional Problems Associated with Inflammatory Bowel Disease

Although IBD is primarily identified as being a disease of the digestive tract, it can be systemic, affecting nearly any organ in the body. These effects are commonly referred to as extraintestinal or non-intestinal symptoms. These symptoms are reasonably common, with 20-45% of individuals experiencing some form of extraintestinal symptom. See below for a summary of these symptoms:

Musculoskeletal

• Arthritis/arthralgia: pain and swelling of the joints that can affect range of motion. Can follow the pattern of gastrointestinal inflammation (i.e., appearing and disappearing with gut symptoms) or occur independently of gut inflammation.
• Ankylosing spondylitis: arthritis of the spinal joints causing pain, stiffness and reduced flexibility/movement of the spine. Often occurs independently of gastrointestinal inflammation.

Skin

• Erythema nodosum: tender red bumps of the skin, typically appearing on the lower parts of the body (e.g., shins, ankles). More common among females. Symptoms usually follow the course of gastrointestinal inflammation.
• Pyoderma gangrenosum: a rarer symptom involving painful, pus-filled lesions on the skin that eventually form deep ulcers. Symptoms usually follow the course of gastrointestinal inflammation.

Eye

• Episcleritis: a painful inflammation of the episclera, the thin, clear outer layer that covers the white part of the eye. Episcleritis causes the eye to become red, irritated and tender.
• Uveitis: inflammation of the middle layer of the eye (uvea). Uveitis can cause pain, blurred vision, redness and sensitivity to light.

Liver

• Primary sclerosing cholangitis (PSC): involves inflammation of the liver and gallbladder resulting in restricted flow of bile. Symptoms include yellowing of the skin (jaundice), fatigue, dark urine, weight loss.

Blood

• Anaemia: low red blood cell count. Symptoms include fatigue, weakness, increased heart rate, shortness of breath. This can be due to many causes, including inflammation, or deficiency of nutrients such as iron.

Lungs:

• Lung disease: Lung disease as a manifestation of IBD is very rare. This can result in inflammation in various areas throughout the pulmonary system. Symptoms can include persistent coughing and shortness of breath.

Kidneys and Urinary Tract

• Kidney stones (Nephrolithiasis): the inability to properly absorb fats allows for the accumulation of oxalate in the kidneys, eventually forming stones. This can cause abdominal or back pain, as well as nausea, vomiting.