How inflammatory bowel disease affects the body

Inflammatory bowel disease (IBD) is a term that generally refers to two chronic (long-term) digestive system conditions that can make like difficult for the patient: ulcerative colitis and Crohn’s disease. But can these conditions have an effect on the body outside the gut? Top Doctors interviewed Dr Stuart Bloom, an expert on Crohn’s and colitis, who explained how these diseases affect the body.

How does inflammatory bowel disease affect the digestive system?

The ways in which inflammatory bowel disease affects the digestive system depends on whether the disease is ulcerative colitis or Crohn’s disease.

Ulcerative colitis tends to affect just the colon (large bowel) and therefore, in general, it presents with bleeding from the back passage and diarrhoea. It can vary in the amount of the colon that it involves, so patients can sometimes get just bleeding associated with some urgency, or some frequent visits to the bathroom without bleeding, or, if the disease affects a larger part of the bowel, there can be a rather unpleasant mixture of blood and diarrhoea, which, again, can affect the patient with frequent lavatory visits, sometimes getting them up in the middle of the night.

Crohn’s disease most commonly presents with abdominal pain and diarrhoea, although in a small proportion of patients, if the large bowel is affected, it can produce bleeding, a bit like colitis. If other parts of the digestive tract are involved, like the oesophagus, the gullet, or the stomach, it can present with upper abdominal pain, indigestion-type symptoms, or problems with swallowing. Sometimes, Crohn’s can affect the bottom area – so-called perianal disease – when it can produce some discharge or some discomfort around the bottom.

How does inflammatory bowel disease affect the rest of the body?

Inflammatory bowel diseases – ulcerative colitis and Crohn’s disease – can sometimes affect other parts of the body.

• The joints – in 15-20% of cases, patients can get joint symptoms, which can sometimes mirror the activity of the inflamed intestines.
• The liver – sometimes, for reasons that we don’t fully understand, the diseases can affect the liver and this produces a condition called primary sclerosing cholangitis (PSC) – a big medical label, but what it actually means is inflammation of the liver which goes with inflammatory bowel disease.
• The skin can also be affected. There are various inflammatory conditions, like pyoderma and erythema nodosum – again, just sort of Latin labels, but detailing rather nasty, painful, inflammatory conditions of the skin, which are usually active when the inflammatory bowel disease is active.
• The eyes – IBD can cause iritis and uveitis, which leads to sore, red eyes.

If you are concerned that you may have Crohn’s or ulcerative colitis, visit your doctor or a specialist.