Extraintestinal Manifestations of Inflammatory Bowel Disease: Current Concepts, Treatment, and Implications for Disease Management

By G. Rogler, A. Singh, A. Kavanaugh, D. Rubin. Gastroenterology, 2021

723 citations recorded by the source corpus.

Inflammatory bowel diseases (IBD) are systemic disease that manifest not only in the gut/GI tract but also in many patients in extraintestinal organs. The quality of life of IBD patients may be significantly affected by those extraintestinal manifestations (EIMs). It is important to have knowledge of the prevalence, pathophysiology and clinical presentation of EIMs in order to adapt therapeutic options to cover all aspects of IBD. EIMs may occur in up to 24% of IBD patients before the onset of intestinal symptoms and need to be recognized to initiate appropriate diagnostic procedures. EIMs most frequently affect joints, skin, or eyes, but may also affect other organs such as the liver, lung and pancreas. It is a frequent misconception that a successful therapy of the intestinal inflammation will be sufficient to treat EIMs satisfactorily in the majority of IBD patients. In general, peripheral arthritis, oral aphthous ulcers, episcleritis, or erythema nodosum may be associated with active intestinal inflammation and may improve upon standard treatment of the intestinal inflammation. On the other hand, anterior uveitis, ankylosing spondylitis (AS) and primary sclerosing cholangitis (PSC) usually occur independent of disease flares. This review provides a comprehensive overview of epidemiology, pathophysiology, clinical presentation and treatment of EIMs in IBD.

Subfields: Epidemiology, Genetics

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