What extraintestinal manifestations means

Simply put, if someone with inflammatory bowel disease (IBD) is experiencing extraintestinal manifestations (EIMs), that means they’re suffering from symptoms outside of the intestine. Intestinal symptoms include things like abdominal pain, diarrhoea, or constipation.

If symptoms related to your IBD affect other parts of your body, then this is considered to be an EIM.

Examples of extraintestinal manifestations

EIMs commonly affect the joints, eyes, skin, mouth, bones, kidneys, and liver. Deficiencies such as anaemia are also considered to be an EIM.

Some of these occur during flares, but they can also develop before IBD is diagnosed or during times of remission.

The list is pretty vast, so it’s definitely worth taking a look into. I’ve included a couple of interesting resources below to start you off.

Extraintestinal manifestations that can be experienced without being in a flare in:

Crohn’s disease – Axial arthritis, polyarticular arthritis, pyoderma gangrenosum, psoriasis, uveitis, hepatobiliary conditions, such as primary sclerosing cholangitis, pericholangitis, steatosis, autoimmune hepatitis, cirrhosis, and gallstones.

Ulcerative colitis – Axial arthritis, polyarticular arthritis, pyoderma gangrenosum, uveitis, hepatobiliary conditions such as primary sclerosing cholangitis, pericholangitis, steatosis, autoimmune hepatitis, cirrhosis, and gallstones.

Extraintestinal manifestations related to disease activity (IBD flare) include: Erythema nodosum, mouth ulcers, episcleritis, metabolic bone disease (osteopenia, osteoporosis, osteomalacia), and venous thromboembolism (VTE), pauci-articular arthritis – this affects fewer than five large joints, such as the ankles, knees, hips, wrists, elbows, and shoulders.

IBD is an immune-mediated disease (IMID). Check out this study which looks at the prevalence of people with IBD being diagnosed with other IMIDs such as asthma (lungs), psoriasis (skin), arthritis (joints), multiple sclerosis (neurological), spondylarthritis (joints), uveitis (eyes), and primary sclerosing cholangitis (liver): Impact of immune-mediated diseases in inflammatory bowel disease.