Extraintestinal manifestations of inflammatory bowel disease affect the musculoskeletal, dermatologic, ocular, renal and pulmonary systems.
Extraintestinal manifestations (EIMs) of inflammatory bowel disease (IBD) are common in both ulcerative colitis and Crohn disease. The systems most often involved are the musculoskeletal and dermatologic systems. Ocular, renal, and pulmonary manifestations also are seen. For the physician managing these already complex patients, an additional diagnosis-erythema nodosum, psoriasis, purpura, arthritis-can be a significant challenge.
In this short podcast, Dr Alan Moss answers several important questions for primary care physicians that address signs and symptoms to watch for in your patients with IBD and how first-line therapy impacts both the GI disease and the extraintestinal presentations.
Extraintestinal Manifestations of IBD
Dr Moss is Assistant Professor of Medicine at Harvard Medical School and is a gastroenterologist at Beth Israel Deaconess Medical Center in Boston. He will be discussing diagnosis and management of extraintestinal manifestations of IBD in his presentation at the 2012 Advances in Inflammatory Bowel Diseases, the Crohn’s & Colitis Foundation’s Clinical & Research Conference, to be held December 13-15 in Hollywood, Florida.
Take home points
•Patients with IBD who present with new eye, skin, joint, or pulmonary symptoms should be evaluated for the possibility of either an associated inflammatory processes, or adverse effects of their immunosuppressant medications
•Extraintestinal symptoms usually correlate with intestinal disease activity; they typically present when the patient’s IBD is active
•Corticosteroids and anti-TNF drugs can also improve inflammatory arthritis or the skin or ocular manifestations of IBD, but specialist care should be sought in these cases to prevent complications
For Further Information
Peyrin-Biroulet L, Loftus EV Jr, Colombel JF, Sandborn WJ. Long-term complications, extraintestinal manifestations, and mortality in adult Crohn's disease in population-based cohorts.Inflamm Bowel Dis. 2011;17:471-478. http://onlinelibrary.wiley.com/doi/10.1002/ibd.21417/pdf.
Barrie A, Regueiro M. Biologic therapy in the management of extraintestinal manifestations of inflammatory bowel disease. Inflamm Bowel Dis. 2007;13:1424-1429. http://onlinelibrary.wiley.com/doi/10.1002/ibd.20196/pdf.