Extraintestinal Manifestations of Inflammatory Bowel Disease

Excerpt

Inflammatory bowel disease (IBD) is a chronic immune-mediated disorder comprised of Crohn disease and ulcerative colitis. Ulcerative colitis affects the large intestines, whereas Crohn disease may affect any part of the gastrointestinal tract (GIT). IBD is a multisystem condition that predominantly affects the gastrointestinal, musculoskeletal, ocular, and cutaneous systems. The complications that arise outside the intestinal inflammation of IBD are known as extraintestinal manifestations (EIMs) of IBD. Regularly, these manifestations result in significant morbidity in IBD patients, even more so than the intestinal disease itself. EIMs present in 5% to 50% of all IBD patients.

The severity and occurrence of EIMs and their correlation with intestinal-IBD activity vary. Most EIMs are directly associated with an ongoing intestinal flare. This includes aphthous ulcers, pauciarticular arthritis, erythema nodosum (EN), and episcleritis. Other EIMs like ankylosing spondylitis(AS) and uveitis are independent of intestinal disease activity. Single or multiple EIMs may arise before or after the intestinal manifestations or diagnosis of IBD. Studies have revealed that the presence of a single EIM increases the likelihood of developing additional EIMs.