2. Extraintestinal symptoms
The inflammation of ulcerative colitis extends to affect organs other than the colon, such as skin, eyes, bone, joints, and liver.
- The mouth is on the affected areas. Mouth lesions occur as mouth ulcers, such as in aphthous stomatitis or angular cheilitis. Aphthous stomatitis is recurrent and benign mouth ulcer. Angular cheilitis is painful ulcers at the mouth angle that may extend to the skin.
- Skin manifestations also occur and include erythema nodosum and pyoderma gangrenosum. Erythema nodosum is the most common skin problem and indicates disease activity. It consists of elevated, tender, and red nodules, usually on the shins. Pyoderma gangrenosum is a more severe lesion; it consists of painful nodules and pustules (pus-filled vesicles) that may ulcerate.
- The eye is also one of the affected organs, especially the iris causing its inflammation (iritis). Eye symptoms include photophobia (eye pain on light exposure) and blurred vision. Iritis requires rapid and proper treatment to avoid permanent vision loss. Eye inflammation may also involve the sclera and episclera.
- Ulcerative colitis can also involve the joints and cause arthritis, which causes painful, red, hot, tender, and swollen joints with limited movement. It has a significant impact on daily life quality. It may involve large joints, such as hip and shoulder joints, or small joints of the hands and feet. It also affects bone and causes osteoporosis, which raises the risk of bone fractures.
- Patients with ulcerative colitis have an increased risk of blood clots by three times more than others. Blood clots manifest as painful leg swelling in deep venous thrombosis or difficult breathing in pulmonary embolism.
- Anemia may occur in ulcerative colitis due to chronic blood loss. Also, it may occur due to bone marrow depression as a result of the chronic disease or due to autoimmune destruction of the red blood cells (autoimmune hemolytic anemia).
- The liver is also one of the affected organs in ulcerative colitis. 5% of patients with ulcerative colitis have primary sclerosing cholangitis (PSC). It is an inflammatory disease that destroys the small and large bile ducts. 75% of the patients with primary sclerosing cholangitis have ulcerative colitis. PSC leads to obstructive jaundice and may end in liver cell failure and liver cirrhosis. It also increases the risk of bile duct cancer and colon cancer. There is no specific curative treatment for PSC. Also, colectomy doesn’t relieve it. Despite the association, the courses of ulcerative colitis and PSC are unrelated.
See your doctor if you have any of the prominent intestinal symptoms to discover ulcerative colitis early if it presents. Early diagnosis helps the management plan to be more effective. It also gives the doctor a chance to prevent life-threatening complications and reduce the disease’s impact on your daily life.