Inflamed intestinal mucosa results in characteristic symptoms such as abdominal pain, cramps or bloating, diarrhoea, weight loss and lethargy, with fever, vomiting and anaemia also typical. Less common signs and symptoms of IBD include arthritis, uveitis (resulting in painful, red eyes), and painful red skin swellings (erythema nodosum).2,5
The long-term effects of IBD can include scarring or narrowing of the bowel which may require surgery. Fistulas are more likely, where the bowel wall is perforated and faecal matter can track through to adjacent organs. Around a quarter of people with Crohn’s develop fistulas, and they are also more likely to develop perianal disease.
Some people develop itching and jaundice due to primary sclerosing cholangitis, a narrowing of bile ducts inside and outside the liver due to inflammatory scarring.4,9,10
Nutrients may not be well absorbed by the body so conditions such as osteoporosis or iron deficiency anaemia are more likely. Malnutrition in children can mean faltering growth, or delayed puberty.4,9
IBD, and particularly ulcerative colitis, increases the risk of the rare but potentially fatal condition of toxic megacolon. This is when, over a few days, the colon dilates so that it is not able to function properly with gas and faeces not being cleared. Symptoms can include abdominal pain, bloating, fever, diarrhoea, rapid heart rate and shock. Treatment is usually by surgery, but if untreated the bowel may perforate or rupture with blood loss and sepsis.11.12
People with IBD have an increased risk of bowel cancer, with risk increasing the longer they have the condition. After 10 years of Crohn’s, bowel cancer risk is around 1 in 50, but increases to a 1 in 5 risk after 30 years. Bowel cancer screening, including colonoscopy, is recommended after 10 years or if several parts of the bowel are affected.2,9