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HIBD Horizon

Part 1 · Understanding your illness · 3/22

Beyond the gut

IBD can also affect the eyes, skin, joints, liver, bones… Recognising these signs means they can be treated better.

Up to 1 patient in 2will one day have a sign outside the gut. It is not “something else”: it is often the same disease showing itself elsewhere.

1Eyes
2Mouth
3Liver
4Joints
5Skin
6Bones
7Blood
8Kidneys

Emergency, don't wait

Painful red eye with blurred vision
Swollen, painful calf
Sudden breathlessness or chest pain

Some follow the flares: knees and ankles, lumps on the shins, a red eye that is not very painful. They settle down with the flare.

Others run their own course: back, uveitis, liver. They need separate follow-up.

The eyes

What it looks like : A red eye that is not very painful (episcleritis), often during a flare. Rarer: a painful red eye, blurred vision, sensitivity to light (uveitis).

What to do : Painful red eye or blurred vision: see an eye specialist urgently.

The mouth

What it looks like : Mouth ulcers that keep coming back, often with flares.

What to do : Mention them: they can also come from a deficiency (iron, B9, B12, zinc).

The liver and bile ducts

What it looks like : Most often nothing you can feel. Sclerosing cholangitis, especially with UC, shows up on a blood test (liver tests).

What to do : Regular liver tests. If it is present: a surveillance colonoscopy every year.

The joints

What it looks like : The most common. Swollen or painful knees, ankles, wrists. Or lower back pain, stiff in the morning.

What to do : Tell your gastro, and avoid ibuprofen: paracetamol, or even a rheumatologist.

The skin

What it looks like : Red, painful lumps on the shins (erythema nodosum), especially during a flare. Rarer: a wound that grows for no reason.

What to do : Show it to a doctor quickly, especially a wound that won't heal.

The bones

What it looks like : Silent osteoporosis: cortisone, lack of vitamin D, inflammation.

What to do : Bone density scan if you have repeated courses of cortisone. Vitamin D and calcium.

The blood

What it looks like : Anaemia (tiredness, breathlessness). And a higher risk of clots (deep vein thrombosis, embolism), especially during a flare or in hospital.

What to do : Swollen, painful calf, or sudden breathlessness: A&E.

The kidneys

What it looks like : Kidney stones are more common, especially if Crohn's affects the ileum or after an operation.

What to do : Drink plenty. Violent pain in the back or side: see a doctor.

The habit to get intoTell your gastro about any new symptom, even if it seems unrelated to your gut. And tell your other doctors (eye specialist, rheumatologist, dermatologist) that you have IBD.