Extraintestinal Manifestations of UC
Extraintestinal Manifestations of Ulcerative Colitis Part I
Ulcerative colitis and Crohns disease are chronic inflammatory conditions primarily involving the intestine. The systemic nature of these diseases, however, may result in pathological processes involving other organ systems. The constellation of disease associated, non-gastrointestinal symptoms experienced by patients are referred to as extraintestinal manifestations (EMs) of IBD. The reason why some IBD patients develop EMs and others do not is not known. It is suspected that both genetics and autoimmunity play a role in the development of symptoms outside the gastrointestinal tract.
Estimates suggest that 20-40% of IBD patients have EMs, with a slightly greater prevalence among individuals with Crohns disease than UC. The most common EMs of UC involve the musculoskeletal system, skin, eyes, and liver. While the vast majority of EMs develop after the diagnosis of UC, 10% of patients may experience non-gastrointestinal symptoms as the first sign of their UC.
Musculoskeletal Manifestations
Arthritis - The arthritis associated with UC is typically described as an aching or stiffness in the knees, hips, ankles, wrists, or elbows. Unlike other forms of arthritis (ie; rheumatoid arthritis/osteoarthritis) the joints tend not to swell or become deformed. It has been suggested that the severity of arthritis correlates with disease extent and activity in the bowel.
Sacroiliitis - Inflammation of the joints of the tailbone is a common cause of low back pain among patients with UC.
Ankylosing spondylitis - Ankylosing spondylitis is a rheumatologic condition of the spine which can exist by itself or in association with UC. Inflammation and fusion of spinal joints results in back pain and stiffness. For further information click on the link below.– http://www.wheelessonline.com/ortho/ankylosing_spondylitis
Skin Manifestations
Erythema nodosum – Erythema nodosum presents with red, painful, warm, raised nodules symmetrically distributed on the legs, and sometimes arms. The appearance of the nodules is often associated with underlying bowel activity and arthritis. For photos and further information -
Pyoderma gangrenosum – Pyoderma gangrenosum begins as a pustular or nodular lesion which subsequently ulcerates and erodes surrounding tissue. These lesions are often seen on the front of the legs, at sites of prior trauma, and around ostomies. Their evolution tends to be independent of bowel activity. For photos and further information click on the link below.– http://postgradmed.com/.../12_02/puzzles_answer.htn