Extraintestinal Complications Of Ibd
Inflammatory bowel disease can cause a variety of symptoms, both in the gut and out of the gut. When the disease affects other parts of the body, this is known as an extraintestinal manifestation or complication. Between 25-40% of IBD patients experience EIMs, commonly in the joints, skin, bones, eyes, kidneys, and liver. Anemia is another extraintestinal complication that IBD patients may experience.
Navigate the list below to learn more about the different potential extraintestinal complications of IBD:
How Is Ulcerative Colitis Treated
Theres no cure for ulcerative colitis, but treatments can calm the inflammation, help you feel better and get you back to your daily activities. Treatment also depends on the severity and the individual, so treatment depends on each persons needs. Usually, healthcare providers manage the disease with medications. If your tests reveal infections that are causing problems, your healthcare provider will treat those underlying conditions and see if that helps.
The goal of medication is to induce and maintain remission, and to improve the quality of life for people with ulcerative colitis. Healthcare providers use several types of medications to calm inflammation in your large intestine. Reducing the swelling and irritation lets the tissue heal. It can also relieve your symptoms so you have less pain and less diarrhea. For children, teenagers and adults, your provider may recommend:
Children and young teenagers are prescribed the same medications. In addition to medications, some doctors also recommend that children take vitamins to get the nutrients they need for health and growth that they may not have gotten through food due to the effects of the disease on the bowel. Ask your healthcare provider for specific advice about the need for vitamin supplementation for your child.
You might need surgery that removes your colon and rectum to:
- Avoid medication side effects.
- Prevent or treat colon cancer .
- Eliminate life-threatening complications such as bleeding.
Living With Uc: Probiotics
These friendly bacteria are similar to those that live in your intestine and prevent the growth of too many harmful bacteria. We need more research to know if probiotics can help with ulcerative colitis. You can find probiotics in some yogurts, milk, tempeh, and soy beverages. Or you can buy them as supplements.
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What Can I Expect If I Have A Diagnosis Of Ulcerative Colitis
Ulcerative colitis is a lifelong condition that can have mild to severe symptoms. For most people, the symptoms come and go. Some people have just one episode and recover. A few others develop a nonstop form that rapidly advances. In up to 30% of people, the disease spreads from the rectum to the colon. When both the rectum and colon are affected, ulcerative symptoms can be worse and happen more often.
You may be able to manage the disease with medications. But surgery to remove your colon and rectum is the only cure. About 30% of people with ulcerative colitis need surgery.
Risk Factors And Prevalence
Ulcerative colitis is more likely to develop between the ages of 15 and 30 years old. Research has also indicated that family history of the disease is a risk factor. Ulcerative colitis is generally more common amongst Caucasians.Jewish populations, specifically Ashkenazi Jews, have a high prevalence of the disease.
Childers, R. E., Eluri, S., Vazquez, C., Weise, R. M., Bayless, T. M., & Hutfless, S. . Family history of inflammatory bowel disease among patients with ulcerative colitis: a systematic review and meta-analysis. Journal of Crohns & colitis, 8, 14801497. .
Cleveland Clinic. . Ulcerative Colitis: Symptoms, Treatment, Living With It & Diagnosis. Cleveland Clinic. .
Misra, R., Faiz, O., Munkholm, P., Burisch, J., & Arebi, N. . Epidemiology of inflammatory bowel disease in racial and ethnic migrant groups. World journal of gastroenterology, 24, 424437. .
Schiff, E. R., Frampton, M., Semplici, F., Bloom, S. L., McCartney, S. A., Vega, R., Lovat, L. B., Wood, E., Hart, A. L., Crespi, D., Furman, M. A., Mann, S., Murray, C. D., Segal, A. W., & Levine, A. P. . A New Look at Familial Risk of Inflammatory Bowel Disease in the Ashkenazi Jewish Population. Digestive diseases and sciences, 63, 30493057. .
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Ways To Reduce The Risk Of An Ulcerative Colitis Emergency
While many patients with ulcerative colitis may experience only mild or occasional symptoms, emergency situations can develop suddenly in both the newly diagnosed and in people who have had ulcerative colitis for a long time.
Keep in mind that the duration of flare-ups can be unpredictable and that remissions can vary in length, which means you always need to be on alert for any new or different symptoms.
The most important control patients have to prevent flare-ups is to continue their maintenance medications, as directed, says Hanauer. Antibiotics can also trigger flares, so they should only be used when appropriate not for colds or viral infections. Quitting smoking can also trigger flare-ups, so patients should discuss smoking cessation with their gastroenterologists.
Hanauer also recommends that patients with ulcerative colitis eat a healthy diet when theyre in remission to help ensure theyre meeting their nutritional requirements.
As the caregiver, youre in a unique position to notice changes in the nature and intensity of your loved ones ulcerative colitis symptoms. Always contact their medical team if you have any questions or suspect that the person with ulcerative colitis is experiencing an emergency. Your prompt action could save a life.
Additional reporting by Jordan M. Davidson.
Plan Your Family Goals
Ulcerative Colitis usually doesnt affect the chances of getting pregnant. But many women have fewer children due to the fear that the disease could be passed on the child. Even though UC doesnt interfere in the pregnancy, it is important to plan it carefully. It is because, if a woman conceives during a flare, theres a high chance that the symptoms could worsen throughout the pregnancy.
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What Is Ulcerative Colitis Exactly
Ulcerative colitis is one of the two main forms of inflammatory bowel disease . The other is Crohns disease. U.C. occurs when the immune system malfunctions, causing inflammation and ulcers to appear on the inner lining of the large intestine, according to the National Institute of Diabetes and Digestive and Kidney Diseases . Its not comfortable, to put it mildly, and not something that will clear up quickly.
Ulcerative colitis is a chronic illness that does not yet have a medical cure. That doesnt mean nothing can be done though, so dont despair if youre experiencing symptoms. Sidhartha Sinha, M.D., a gastroenterologist, assistant professor at Stanford Medicine, and researcher who specializes in IBD, tells SELF that while there arent medical cures for ulcerative colitis, there are medical treatments. And we have made great advancements in these treatments, he says. The last resort is a surgical option called colectomythe removal of the entire colonwhich can eliminate U.C. entirely.
Crohns Vs Ulcerative Colitis Symptoms
Crohns disease and ulcerative colitis are the two primary types of IBD and cause similar symptoms.
Crohns disease is an inflammatory bowel disease that can affect any part of your GI tract between your mouth and your anus. It typically affects the end of your small intestines or the first part of your large intestines.
Heres a look at how the most common symptoms of these two conditions typically compare.
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What Are The Main Types Of Ibd
|Crohns Disease||Ulcerative Colitis|
|Affected Location||Can affect any part of the GI tract Most often it affects the portion of the small intestine before the large intestine/colon.||Occurs in the large intestine and the rectum.|
|Damaged Areas||Damaged areas appear in patches that are next to areas of healthy tissue.||Damaged areas are continuous usually starting at the rectum and spreading further into the colon.|
|Inflammation||Inflammation may reach through the multiple layers of the walls of the GI tract.||Inflammation is present only in the innermost layer of the lining of the colon.|
How Do I Know I Have Sacroiliitis
Pain is the main symptom of sacroiliitis. Youll feel it in your lower back, buttock, hip, or thigh. Sometimes the pain might spread down your leg and even to your feet.
Back pain can also be a sign of an injury. The difference is that sacroiliitis pain typically lasts for more than 3 months. Its worse when you first wake up in the morning, and it improves when you move.
If you have lower back pain thats not getting better, see a rheumatologist. Thatâs a specialist who diagnoses and treats arthritis. The doctor will do a physical examination and press on parts of your lower back, hips, or legs to find the painful areas.
Another way to diagnose sacroiliitis is with imaging tests like X-ray, magnetic resonance imaging , or computed tomography . These scans will show if you have any problems in your sacroiliac joint.
Signs of sacroiliitis could show up on an X-ray even before you have any symptoms. Or the doctor might find sacroiliitis accidentally on a CT to check your IBD.
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Presentation Of Disease At Diagnosis
Several attempts have been made in the past few years to define clinical presentation of late-onset UC and to determine if this variant may be different from adult forms.
Compared with adult-onset UC, more frequent weight loss but less frequent rectal bleeding and systemic symptoms like fever have been reported in older populations with UC onset . In particular, UC onset in older patients requires a careful diagnostic work-up to differentiate between drug-induced colitis , segmental colitis associated with diverticular disease, ischemic or infectious colitis or even neoplastic disease , and this may lead to the significant diagnostic delay reported in late-onset disease . Concerning disease extension at diagnosis , in a meta-analysis from 2016, left-sided colitis prevails in older-onset disease . This finding was confirmed by subsequent studies , whereas in other studies, extensive colitis or proctitis were more frequent in late-onset UC. Some studies found significant differences for disease extension at diagnosis between adult- versus late-onset UC , whereas others did not find such differences . Taken together, Fig. 1 depicts the most important studies in the past decade concerning disease extension at diagnosis including, where available, the corresponding figure of adult-onset UC.
Table 1 Comparison of the main features of ulcerative colitis at diagnosis and follow-up over 5 years, between adulthood-onset and late-onset diseaseFig. 1
What Should I Ask My Doctor
If you have ulcerative colitis, you may want to ask your healthcare provider:
- How much of my large intestine is affected?
- What risks or side effects can I expect from the medication?
- Should I change my diet?
- Will ulcerative colitis affect my ability to get pregnant?
- What can I do at home to manage my symptoms?
- What are my surgical options?
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What Are The Symptoms Of Ulcerative Colitis With Constipation
Thereâs no agreed-upon definition for UC with constipation. But a group of experts came up with a set of guidelines to better pinpoint it. In general, youâll need to have at least two of the following symptoms for at least 3 days a month during the prior 3 months:
- A sensation that you canât get all your stool out
Constipation may also cause:
- A sick feeling in your stomach
The above symptoms can lead to other health issues, especially if you strain really hard when you poop. You may get:
- Tears or sores in the lining of your anus
- Swollen blood vessels around your anus
- Hard stool that gets stuck in your rectum
Ulcerative Colitis In Children
According to one study of IBD in the United States, 1 in 1,299 children between ages 2 and 17 years old were affected by the condition in 2016. Crohns disease was twice as common as UC, and boys were more likely to have IBD than girls.
For children with IBD, a diagnosis is more likely after 10 years old.
UC symptoms in children are similar to symptoms in older individuals. Children may experience bloody diarrhea, abdominal pain and cramping, and fatigue.
In addition, they may experience issues compounded by the condition, such as:
- anemia due to blood loss
- malnutrition from poor eating
- unexplained weight loss
UC can have a significant effect on a childs life, especially if the condition isnt treated and managed properly. Treatments for children are more limited because of possible complications. For example, medicated enemas are rarely used as a treatment method in children.
However, children with UC may be prescribed medications that reduce inflammation and prevent immune system attacks on the colon. For some children, surgery may be necessary to manage symptoms.
If your child has been diagnosed with UC, its important that you work closely with their doctor to find treatments and lifestyle changes that can help. Check out these tips for parents and children dealing with UC.
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Ulcerative Colitis Vs Crohns Disease Vs Irritable Bowel
Other gut diseases can have some of the same symptoms.
- Ulcerative colitis affects only your large intestine and its lining.
- Crohnâs disease causes inflammation, but it affects other places in your digestive tract.
- Irritable bowel syndrome has some of the same symptoms as UC, but it doesnât cause inflammation or ulcers. Instead, itâs a problem with the muscles in your intestines.
What Else Should I Know About Ulcerative Colitis
Poor appetite, diarrhea, and poor digestion of nutrients can make it hard for teens with ulcerative colitis to get the calories and nutrients the body needs. Be sure to eat a variety of foods, get plenty of fluids, and avoid foods that make your symptoms worse. Some teens may need supplements, like calcium or vitamin D. Someone who isnt growing well may need other nutrition support.
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Is Ulcerative Colitis Curable
Currently, theres no nonsurgical cure for UC. Treatments for the inflammatory disease aim to extend periods of remission and make flare-ups less severe.
For people with severe UC, curative surgery is a treatment option. Removing the entire large intestine will end the symptoms of UC.
This procedure requires your doctor to create a pouch on the outside of your body where waste can empty. This pouch can become inflamed and cause side effects.
For that reason, some people choose to have only a partial colectomy. In this surgery, your doctor only removes the parts of the colon that are affected by UC.
While these surgeries can help ease or end symptoms of UC, they can have adverse effects and possible long-term complications. Read more about these issues to determine if surgery is an option for you.
Symptoms By Type Of Ulcerative Colitis
Ulcerative colitis can be broken into subtypes depending on where the inflammation is in your colon.
- Ulcerative proctitis. Ulcerative proctitis affects your rectum, the part of your colon closest to your anus. Its the most common type and affects 30 to 60 percent of people with ulcerative colitis.
- Proctosigmoiditis. Proctosigmoiditis causes inflammation of your rectum and the lower part of your colon, called the sigmoid colon.
- Left-sided colitis. Left-sided colitis affects your rectum, your sigmoid colon, and the descending part of your colon on the left side of your body.
- Pancolitis.Pancolitis affects your entire colon.
Symptoms typically become worse as inflammation spreads farther along your colon.
show ulcerative colitis is slightly more prevalent in men, but most studies show no difference.
Symptoms of ulcerative colitis are similar regardless of sex, but unique issues may occur for some people.
Rectovaginal fistulas may develop, which are holes that allow stool to leak from the bowel to the vagina.
Ulcerative colitis may also lead to irregular periods or increased menstrual pain. Women may also be at a higher risk of anemia and osteoporosis, and ulcerative colitis can further increase this risk.
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Information Sources And Search Strategy
We will systematically search PubMed, Web of Science, MEDLINE, CINAHL, the Cochrane Library, Embase, China National Knowledge Infrastructure , Chinese Biomedical Literature database , and WANFANG database for related randomized controlled trials that compared one TCM intervention with another or with 5-ASA in the treatment of mild-to-moderate UC. The temporal interval is limited from the time that the databases created to February 2019.
The searches were restricted to papers that were published in English or Chinese. The search strategy will be conducted independently by 2 authors who are experienced in the information retrieval and combine free text words and medical subject headings regarding Chinese medicine,traditional Chinese medicine,Chinese herbal,Ulcerative colitis, UC,Inflammatory bowel disease,IBD, and randomized controlled trials. MeSH and subheadings were combined with AND or OR. Furthermore, we will also retrieve the WHO International Clinical Trials Registry Platform and ClinicalTrials.gov to identify ongoing trial registers. We will manually search related systematic reviews/meta-analyses and bibliographies of included studies to identify additional potential studies. The preliminary search strategy for PubMed is summarized in Table Table1,1, which will be adapted according to syntax-related requirements of other electronic databases.
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Effects Of Crohns Disease And Ulcerative Colitis
Every person responds differently to IBD. The severity of symptoms will vary from time to time and from person to person. IBD is not a progressive disease . Rather, flare-ups can range from mild to severe and back to mild again. Some people will experience periods of relief from symptoms in between flare-ups.We cannot predict how long a person will stay free from symptoms, or when their next flare-up will occur. Some flare-ups settle down quite quickly with treatment. Other times, it may take months for a persons symptoms to respond to treatment.IBD interferes with a persons normal body functions. Signs and symptoms can include:
- pain in the abdomen
- delayed or impaired growth in children.
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