Ocular
The incidence of ocular complications in IBM patients is 1 to 10%.
The most common is:
- anterior uveitis, Anterior uveitis
- episcleritis.
Symptoms include: - ocular pain,
- photophobia, - blurred vision, - headache
Diffuse episcleritis
Urologic
The most frequent genitourinary complications are: calculi, ureteral
obstruction, fistulas
The highest frequency of nephrolithiasis (10-20%) occurs in patients with CD.
Complication |
Prevalence |
Anemia |
9-74% |
Inflammatory arthritis |
10-35% |
Gall stones (esp. in Crohn disease) |
13-34% |
Scleritis |
18% |
Anterior uveitis |
17% |
Aphthous stomatitis |
4-20% |
Osteoporosis |
2-20% |
Erythema nodosum |
2-20% |
Larson S, Bendtzen K, Nielsen OH. Ann Med. 2010;42:97-114.
Hemorrhage
Perforation
Stricture
Toxic megacolon (transverse colon with a diameter of more than 5,0 cm to 6,0 cm with loss of haustration)
Dysplasia
In Crohn’s disease, increased risk of cancer of the affected areas
In ulcerative colitis, 8-10 years after initial diagnosis, there is a steady, significant increased risk of developing cancer
Prognostic factors increasing malignancy risk in UC:
▪Duration of disease > 10 yrs
▪Pancolonic involvement
▪Continuous progressive disease
▪Severe initial onset
▪Associated liver disease
Bowel
obstruction:
-severe cramping, -nausea, -vomiting, -swollen belly.
Laboratory studies :
Complete blood count (CBC)Blood chemistry including
electrolytes, renal function tests, liver function tests, and blood glucose
Erythrocyte sedimentation rate (ESR)
C-reactive protein (CRP)
Serum iron and vitamin B12 levels
Endoscopy
Imaging studies:
x-rays
barium enemasCT scans
MRI
Antibody tests :
Antineutrophil cytoplasmic antibodies (pANCA)
anti-Saccharomyces cerevisiae antibodies (ASCA)
Anti-OmpC antibody
C-reactive protein Stool markers (testing
for fecal calprotectin)
Symptoms |
Uicerative colitis |
Crohn’s disease |
|
|
|
Rectal involvement |
~ 100% |
50% |
|
|
|
Involvement |
continuous |
discontinuous |
|
|
|
Impairment |
Mucosa+submucosa |
Transmural |
|
|
|
Rectal bleeding |
common |
occasional |
|
|
|
Abdominal pain |
uncommon |
common |
|
|
|
Fistula formation |
rare |
common |
|
|
|
Stricture & obstruction |
rare |
common |
|
|
|
Perirectal, perianal abscesses |
uncommon |
common |
|
|
|
Small bowel |
not involved |
often involved |
|
|
|
Risk of malignancy |
greatly increased |
increased |
|
|
|
Antibody tests |
pANCA + |
ASCA + |
|
|
anti-OmpC+ |
