Study of extra-intestinal manifestations of inflammatory bowel disease

Background: There is a paucity of reports on extraintestinal manifestations (EIMs) in patients with inflammatory bowel diseases (IBD) from south India.
Methods: From November 2016 to December 2018, consecutive IBD patients, both newly diagnosed as well as already diagnosed IBD patients who were willing to consent for detailed clinical examination and investigations were enrolled in the study. The disease phenotype or severity and location were classified according to the Montréal classification. All underwent magnetic resonance imaging (MRI) of sacroiliac joints, LFT, transabdominal ultrasound, and dual energy X-ray absorptiometry (DEXA) scanning at neck femur (bilateral) and L4-L5 spine.
Results: Sixty patients were analysed, 31 had Crohn’s disease (CD) and 29 had ulcerative colitis (UC). Thirty-four percent had at least one while 16 % suffered from multiple EIMs. Except for episcleritis, the frequency of individual EIMs did not differ between CD and UC patients. Twenty-two percent had peripheral arthritis, 12 % had ankylosing spondylitis, and 15 % had ophthalmological manifestations. Mucocutaneous manifestations, aphthous stomatitis, erythema nodosum and pyoderma gangrenosum (PG), were seen in 9 %. None had primary sclerosing cholangitis (PSC). More than half of patients had either osteopenia or osteoporosis on DEXA. Multivariable analysis revealed severe disease, and steroid usage were significantly associated with the presence of EIMs.
Conclusion: The prevalence of EIM is similar to that reported from west, albeit higher than that previously reported among Asian patients. Severe disease, and steroid use were associated with EIM.