Extraintestinal
   Manifestations

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Possible Complications

The complications of Crohn's disease and ulcerative colitis ( collectively known as inflammatory bowel disease, or IBD) are generally categorized as either local or systemic. The term "local" refers to a complication involving the intestinal tract itself. The term "systemic" (or extraintestinal) refers to complications involving other organs or complications that affect the patient as a whole -- rather than just the bowel.

In uncomplicated IBD, appropriate treatment of inflammation results in clinical improvement. The patient gets better. When a complication occurs, however, the improvement is delayed, and a specific treatment may be needed to target and resolve that complication. It is important for patients and physicians to be acquainted with these complications because early recognition often means more effective treatment. Many of the same complications occur in both Crohn's disease and ulcerative colitis, and are discussed together. Other complications are specific for ulcerative colitis or Crohn's disease.

What Are the Systemic (Extraintestinal) Complications of IBD?

Systemic complications -- which include fever, weakness, and loss of appetite -- are a reflection of the inflammation in the small intestine and/or colon. But there are also some people with IBD who suffer from certain types of arthritis, skin conditions, inflammation of the eyes, liver and kidney disorders, and bone loss. Of all the extraintestinal complications, arthritis is the most common. Joint, eye, and skin complications often occur together. For unknown reasons, the extraintestinal or systemic manifestations may predominate in children and even overshadow the intestinal symptoms, which may make diagnosis even more difficult. It is, therefore, important to keep close watch on youngsters who fail to grow or thrive, feel sick, have fever, and complain of general malaise and weakness. These may be systemic manifestations of IBD.

What Causes These Extraintestinal Manifestations? The cause is not known, but it is believed that all of these complications represent an abnormal response of the immune system (the body's line of defense). As the immune system reacts, it triggers inflammation in other parts of the body -- as well as in the intestine. It is also not known why some individuals are affected and others are not.

For more information about extraintestinal complications, please see the documents below. While you may never have any of these complications, it's important to be aware of them and to see your doctor if you experience any changes in your condition. Remember: Identifying potential complications early can be the key to more effective treatment.

Sometimes in people with Inflammatory Bowel Disease other areas of the body are affected as well. When these afflictions are present along with IBD, they are called extraintestinal manifestations. There are a variety of these, but the main ones are:

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