Abstract
Extraintestinal manifestations (EIM) in inflammatory bowel disease (IBD) are frequent and may occur before or after IBD diagnosis. EIM may impact the quality of life for patients with IBD significantly requiring specific treatment depending on the affected organ(s). They most frequently affect joints, skin, or eyes, but can also less frequently involve other organs such as liver, lungs, or pancreas. Certain EIM, such as peripheral arthritis, oral aphthous ulcers, episcleritis, or erythema nodosum, are frequently associated with active intestinal inflammation and usually improve by treatment of the intestinal activity. Other EIM, such as uveitis or ankylosing spondylitis, usually occur independent of intestinal inflammatory activity. For other not so rare EIM, such as pyoderma gangrenosum and primary sclerosing cholangitis, the association with the activity of the underlying IBD is unclear. Successful therapy of EIM is essential for improving quality of life of patients with IBD. Besides other options, tumor necrosis factor antibody therapy is an important therapy for EIM in patients with IBD.
Highlights
Extraintestinal manifestations of inflammatory bowel disease are prevalent in both ulcerative colitis and Crohn’s disease
We review the major Extraintestinal manifestations (EIMs) of inflammatory bowel disease (IBD) and strategies for their management
Calcium oxalate stones patients, Aghazadeh and associates showed that 31.4% of ulcerative colitis (UC) patients and 40.4% of Crohn’s disease (CD) patients had 1 of the 5 major manifestations; a smaller percentage of patients had more than 1 major EIM.[4]
Summary
Dr Levine is an Associate Physician in the Division of Gastroenterology, Hepatology, and Endoscopy at Brigham and Women’s Hospital and an Instructor of Medicine at Harvard Medical School, both in Boston, Massachusetts. Dr Burakoff is Clinical Chief of the Division of Gastroenterology, Hepatology, and Endoscopy at Brigham and Women’s Hospital and an Associate Professor at Harvard Medical School
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