The extra-intestinal manifestations of IBD you had no idea existed

I’ve been short of blog inspiration recently- so I put a request out to you all asking what you’d like to see. Lots of you mentioned that more awareness needs to be given to the extra-intestinal manifestations of IBD: in other words the symptoms that have nothing to do with your gut whatsoever but still cause you a lot of pain. Because newsflash: Inflammatory Bowel Disease can impact every part of your body. 

It’s though 25-40% of IBD patients struggle with EIMs so while that’s a substantial number; it’s also worth noting that lots of patients don’t struggle with any. So, rather than scaremongering, let’s take a look at the facts.

Your eyes

Inflammation of the eyes is possible- the most common version of this being ‘ episcleritis’ which causes a layer of tissue in the eye to become red and inflamed.


Your Skin

So, there are several ways that IBD might impact your skin and this one of the most common EMIs to have. Having Psoriasis is much more common if you have IBD: about 11% of Americans with IBD have psoriasis; compared to 2% of the general population.  You can read more about how psoriasis links to IBD here. Another condition is erythema nodosum (which causes painful red lumps).


Change in Menstrual Cycles

IBD can have a massive impact on your hormone cycle and your period. It might cause the loss of your period, changes in your cycle or you might find symptoms are worse when you’re on your period. Read more about this in my guide to periods and IBD  It’s important to realise this won’t be forever and once IBD is controlled, it’s thought to have little impact on your fertility. Both Iron and Vitamin B can play a role in regulating our menstrual cycle; so make sure you’re checked for any deficiencies.

The Musculoskeletal System 

The most common of the EMIs are problems with our joints and bones. There are all sorts of things that IBD can do to your musculoskeletal system- from joint pain to osteoporosis and fibromyalgia.

Problems with the Pancreas, Liver and Kidneys


So problems with the pancreas, liver and kidneys are all possible for IBD patients. PSC-a serious liver disorder-has a strong connection with IBD; about 75% of PSC have Ulcerative Colitis. Sounds scary but it’s still actually rare to develop it if you have IBD- only about 2-5% of us actually do.

Pancreatitis is also often caused by the drugs many of us with IBD take (usually Azathioprine) so it’s important to be aware of the symptoms. 

Finally, fistulas can occur in the urinary tract- these can be painful and difficult to treat.

If you take medication for IBD, it’s always important that your liver and kidney function are tested very regularly.

Our Lungs

adult, air, beautiful

So, I didn’t know this before researching- but IBD can impact our pulmonary function too.  The airways can become inflamed and certain drugs can also increase the risk of lung disease.


Fatigue is very common with IBD. In fact, when I wrote about what life in remission with IBD  (a fascinating read where over 300 of you shared your thoughts) is like, lots of you explained you still struggle with IBD when your other symptoms were ok. Fatigue is caused by lots of different factors- such as sleep being disturbed and nutritional deficiencies. If you haven’t already, I’d highly recommend guide to periods and IBD  

Mental Health

If you’ve read my blog before, you’ll know I am all about talking about anxiety with IBD. Anxiety is twice as likely to occur if you have Crohn’s disease- for all sorts of reasons. You can read my full guide to how IBD can impact your state of mind here. And, please never be afraid to reach out and let others know you are struggling.

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1 Comment

  1. Jill
    October 31, 2017 / 6:21 pm

    Interestingly I have been taking Restasis ‘Cyclosporine Ophalmic Emulsion’for dry eyes the past 5 months. It takes up to 8 months to work, after 5 months my eyes started to weep strong costic tears that left my eyes inflamed and the skin around them raw. At this same time, I started with Diarrhea, both symptoms went on for a month before I went to my GP. The night before my visit I googled Restasis and Diarrhea not expecting anything, I mean who would think that eye drops can course Diarrhea and to my surprise got results. 2.4% of people on Restasis will get Diarrhea, 91% of them women and over 60% over the age of 60. Yep, I fit the profile! while my GP had an open mind the Ophthalmologist did not, his answer’ no, never heard of it’ I live in Canada.

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