Clinical management of the most common extra-intestinal manifestations in patients with inflammatory bowel disease focused on the joints, skin and eyes

United European Gastroenterol J. 2020 Nov;8(9):1031-1044. doi: 10.1177/2050640620958902. Epub 2020 Sep 14.

Abstract

Extra-intestinal manifestations (EIMs) of inflammatory bowel disease (IBD) occur frequently and contribute to morbidity and reduced quality of life. The musculoskeletal, ocular and cutaneous organ systems are frequently involved in IBD-related EIMs. By focusing on manifestations involving the joints, skin and eyes, this review will discuss the most common clinically relevant and burdensome EIMs that affect IBD patients, and strives for early recognition, adequate treatment and timely referral. For this purpose, we aimed to create a comprehensive overview on this topic, with the main focus on the treatment of reactive and associated EIMs, including spondyloarthropathies, pyoderma gangrenosum, erythema nodosum, psoriasis and anterior uveitis. The recently developed biologicals enable simultaneous treatment of inflammatory disorders. This review can be used as a helpful guide in daily clinical practice for physicians who are involved in the treatment of IBD patients.

Keywords: Crohn’s disease; Inflammatory bowel disease; cutaneous manifestation; extra-intestinal manifestation; musculoskeletal manifestation; ocular manifestation; therapy; treatment; ulcerative colitis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Administration, Oral
  • Administration, Topical
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage*
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Arthralgia / diagnosis*
  • Arthralgia / drug therapy
  • Arthralgia / epidemiology
  • Arthralgia / immunology
  • Colitis, Ulcerative / complications*
  • Colitis, Ulcerative / drug therapy
  • Colitis, Ulcerative / immunology
  • Crohn Disease / complications
  • Crohn Disease / drug therapy
  • Crohn Disease / immunology
  • Diagnosis, Differential
  • Erythema Nodosum / diagnosis*
  • Erythema Nodosum / drug therapy
  • Erythema Nodosum / epidemiology
  • Erythema Nodosum / immunology
  • Eye Diseases / diagnosis*
  • Eye Diseases / drug therapy
  • Eye Diseases / epidemiology
  • Eye Diseases / immunology
  • Female
  • Humans
  • Mesalamine / administration & dosage
  • Mesalamine / adverse effects
  • Middle Aged
  • Prednisolone / therapeutic use
  • Prevalence
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Mesalamine
  • Prednisolone