Inflammatory bowel disease is a serious gastrointestinal condition. It mainly affects the large intestine and specifically the colon but can also involve any other part of the gut, from the mouth to the rectum. Apart from the debilitating symptoms of IBD, especially during flareups, this disease can also progress to complications. Some of these complications can be deadly.
Read more on inflammatory bowel disease.
As the name suggest, inflammation is a key feature of inflammatory bowel disease. Inflammation is the body’s response to tissue damage. It is usually a short term response. While it helps to minimize damage, inflammation can also have a detrimental effect on the affected tissue particularly in the long term. In addition the abnormal immune activity which causes bowel inflammation may also extend beyond the bowels and gut to other parts of the body.
Inflammatory bowel disease (IBD) should not be confused with irritable bowel syndrome (IBS). The latter is known as a functional bowel disorder. There is no inflammation in IBS and no other tissue abnormality. Instead irritable bowel syndrome appears to be a disturbance with the activity of the bowel muscles. IBS is not as ‘dangerous’ as IBD but can cause debilitating symptoms which can adversely affect a person’s life.
Read more on IBS vs IBD.
Complications of IBD
Complications of a disease are the consequences of a condition progressing or persisting. These consequences worsen the condition or lead to other conditions which can be more serious and even deadly. Complications occur in almost all diseases but not all complications are severe or life-threatening. The same applies to inflammatory bowel disease (IBD) complications.
Some IBD complications can be severe and others may not be. Some can be life-threatening while most IBD complications are not. These complications are not isolated to the bowels or gut (intestinal complications). IBD complications can also extend to other parts of the body and ths is known as extra-intestinal complications.
It is important to note that some complications may be more common in one type of inflammatory bowel disease than it is in the other. Crohn’s disease is a type of IBD that can affect any part of the gut and inflammation may extend across the entire thickness of the wall. Ulcerative colitis is the other type of IBD and is isolated to the colon and rectum. Inflammation in ulcerative colitis is usually limited to the inner layers of the colon and rectal wall.
Intestinal Complications of IBD
- Strictures are narrowings that occur in the affected portion of the gut. A minor narrowing may not cause any problem. It may occur with swelling due to inflammation or with scar tissue and tends to be more severe in ulcerative colitis. Sometimes this can lead to a blockage.
- Fistulas are abnormal channels that forms between two hollow organs. It is more likely to occur in Crohn’s disease. These channels may form between different parts of the bowel, the bowel and bladder, rectum and vagina, bowel and skin and similar neighboring organs.
- Abscesses are collections of pus within tissue. Abdominal or pelvic abscesses are more likely to occur with Crohn’s diseases. It may not be limited to the bowel wall but occur in surrounding organs when inflammation extends through the bowel wall.
- Perforation of the gut is another complication of IBD and may precede an abscess. It is more likely to occur with Crohn’s disease but may also occur in ulcerative colitis. This tear or ‘hole’ in the gut occurs at the affected portion when inflammation extends through the wall and weakens it.
- Toxic megacolon is more commonly seen with ulcerative colitis. The colon is inflamed (colitis) and due to the associated swelling it widens excessively (dilatation). There is a risk of bowel perforation in toxic megacolon. This condition is potentially life-threatening.
- Infections of the colon (infectious colitis) may occur in inflammatory bowel disease and especially in ulcerative colitis. It arises in the already inflamed colon (superimposed infection). Clostridium difficile is the most commo bacterium to cause infectious colitis in IBD.
- Cancer of the colon and rectum (colorectal cancer) is one of the more serious and life-threatening complications of inflammatory bowel disease (IBD). It is more likely to occur in ulcerative colitis where patients have as high as a 30-fold greater risk of colorectal cancer. The risk is not as great with Crohn’s disease unless the entire colon is inflamed.
Extraintestinal Complications of IBD
- Arthritis is inflammation of the joints. Central arthritis (specifically ankylosing spondylitis or sacroilitis) and peripheral arthritis may occur in IBD, especially in Crohn’s disease.
- Eye problems may also occur in IBD. Inflammation may occur in the superficial layers of the eyeball, like in epislecritis, or deeper layers like the iris (iritis).
- Skin conditions may also be associated with inflammatory bowel disease. The two major skin conditions seen in IBD are erythema nodosum and pyoderma gangrenosum.
- Kidney stones are one of the urinary complications that occurs in IBD and specifically in Crohn’s disease. Inflammation from the bowels may extend to the ureters causing ureteritis.
- Mouth ulcers or aphthous ulcers are open sores in the oral cavity. It is commonly senn in inflammatory bowel disease (IBD).
- Gallstones are common in Crohn’s disease and a host of other gallbladder and bile duct diseases may also occur in IBD. This includes pericholangitis and primary sclerosing cholangitis.
- Blood clotting disorders can occur in IBD and mainly causes hypercoagulable states where there is an increased risk of blood clots. It can lead to conditions like strokes, DVT and pulmonary embolism.
- Osteoporosis is weakening of the bones due to a reduction in the bone density. It can occur in IBD when the absorption of calcium from the bowels is impaired. Corticosteroid use, which is one approach to treating and managing IBD, can also impair calcium absorption.
How Dangerous is IBD?
The extent of danger in inflammatory bowel disease (IBD) depends on whether certain complications arise or not. It is important to note that not every person with IBD will develop serious and life-threatening complications such as colorectal cancer. However, the risk of colorectal cancer is high, especially in ulcerative colitis.
Colorectal cancer is not the only serious and life-threatening complications in inflammatory bowel disease. Acute megacolon, perforations and blood clotting disturbances are some of the other serious and potentially life-threating complications. Therefore it is not possible to definitely state that IBS is dangerous for every person.