Inflammatory bowel disease (IBD) is a form of chronic inflammation of the stomach. Ulcerative colitis, which is marked by persistent inflammation of the big intestine, and Crohn's disease, which causes inflammatory patches and may occur anywhere within the stomach, are each kinds of IBD. Patients with IBD may experience quite a lot of gastrointestinal symptoms akin to abdominal pain, diarrhea, blood of their stools, bloating, and weight reduction.
What conditions outside the GI tract can individuals with IBD have?
Symptoms of IBD could be each out and in of the gastrointestinal tract. The latter are often known as extraintestinal manifestations (EIMs) of IBD. These conditions occur in about half of all individuals with IBD, and should be present before and/or after someone is diagnosed with IBD. EIMs occur more continuously in individuals who receive their diagnosis at a younger age, and typically occur earlier in the middle of IBD. In fact, about 24% of EIM symptoms are present before receiving a diagnosis of IBD. The causes of EIMs aren’t well understood but, like IBD, could also be as a consequence of a mix of genetic risk aspects, immune response, and lifestyle aspects akin to smoking.
What are some examples of extraintestinal manifestations of IBD?
Patients could have multiple EIMs at the identical time, with various severity. Detecting EIMs may not be easy., and almost any organ system could be affected. Sometimes the severity of EIM symptoms mirrors those of the bowel, but in some cases EIMs behave independently. Below are some common examples of extraintestinal manifestations.
Musculoskeletal: Musculoskeletal manifestations of IBD are probably the most common, occurring in 46% of IBD patients. These can present as inflammatory back pain (ankylosing spondylitis), inflammation of tendons or ligaments, arthritis, joint pain without arthritis, or swelling of fingers or toes (dactylitis). Arthritis can occur each within the axial skeleton (hips, lower back, spine) or peripherally (fingers, wrists, elbows, knees, ankles).
mucus: IBD could cause changes within the skin and mucosa (the moist lining that covers certain organs and cavities within the body). Oral aphthous ulcers (seen with Crohn's disease), erythema nodosum (raised purple nodules, normally on the front of the legs, which can occur in 10% to fifteen% of patients), and pyoderma gangrenosum (skin (painful ulcers) are some examples of this. IBD can affect the skin. Sweet's syndrome, which involves tender nodules under the skin and can be related to elevated white blood cell counts, fever, arthritis, and eye symptoms, is a rare EIM.
Eye: Inflammation of some a part of the attention (episcleritis, scleritis, or anterior uveitis) affects 2% to 7% of patients with IBD. If patients experience eye pain, redness, sensitivity, or visual changes, prompt evaluation by an ophthalmologist could also be mandatory, due to risk of blindness from uncontrolled inflammation.
Vascular: Patients with IBD are thrice more prone to develop blood clots than patients without IBD. Sometimes these clots can travel to the lungs and are called pulmonary embolism. Symptoms of a blood clot may include swelling within the legs or shortness of breath. Poorly controlled inflammation within the GI tract is believed to cause an increased risk of clotting.
Gastrointestinal: Although not common, patients can develop liver diseases related to IBD, including primary sclerosing cholangitis (inflammation and scarring of the bile ducts) and autoimmune hepatitis (when the immune system attacks liver cells, causing liver damage). inflammation). Autoimmune pancreatitis has also been reported. These conditions could be diagnosed by symptoms, blood tests, or imaging results (sometimes using an MRI).
How are EIMs treated?
Intestinal inflammation should be treated effectively, as it might reduce extraintestinal expression activity. Sometimes, EIMs may require additional specific treatment. For example, corticosteroids, sulfasalazine (anti-inflammatory drugs) or certain biologics could also be considered to treat arthritis. Cutaneous and ocular manifestations of IBD could be treated with topical or systemic corticosteroids, immunosuppressants, or specific biological therapies. Vascular manifestations akin to blood clots could be treated with anticoagulation medications. Treatment of EIMs is complex, and sometimes requires collaborative care with health care providers.
What should I do if I’m experiencing symptoms?
Recognizing EIMs is significant, as they’ll significantly impact your quality of life and your doctors' approach to treating and monitoring IBD over time.
Whether or not you've been diagnosed with IBD, it's essential to make an appointment together with your primary care doctor or gastroenterologist (if you’ve one) to debate the symptoms you're experiencing. . Your doctor will discuss your medical and family history to find out your risk for IBD or other medical conditions.
For patients diagnosed with IBD or in danger for IBD, EIMs would be the first indication of a diagnosis or need for treatment review and adjustment. It is significant to report each your gastrointestinal and non-gastrointestinal symptoms to your gastroenterologist in order that appropriate treatment could be initiated immediately and referral to specialists for the affected organ system. Lifestyle changes akin to quitting smoking may additionally help. Reduce risk of EIMs
With targeted treatment and an appropriate healthcare team, management of each IBD and EIMs could be achieved to enhance patients' quality of life.