Systemic symptoms

Symptoms of arthritis may occur in as many as 26 percent of patients with ulcerative colitis. Arthritic symptoms may show up even before inflammatory bowel disease is diagnosed. About 12 to 23 percent of patients with ulcerative colitis have peripheral arthritis, or pain and swelling that affects the large, weight-bearing joints such as the knees and ankles. If UC worsens or becomes exacerbated, arthritis signs and symptoms often accompany the change in condition. Spondylitis, or inflammation of the vertebrae, occurs in about 3 percent of UC patients who also have arthritis complications.

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Nineteen percent of patients with ulcerative pancolitis (UC that involves the entire colon) experience dermatological disorders. These can include a skin condition called erythemia nodosum, in which small, tender, red nodules appear under the skin, accompanied by fever and transitory arthritic symptoms. Another possible skin disorder is pyoderma gangrenosum. Thought to be an immune reaction, this condition causes soft, red nodules on top of the skin that ulcerate, turning purple-red around the edges. Psoriasis, a common skin disease appearing as reddish, silvery-scaly skin, can accompany UC.

About 5 percent of patients with extensive ulcerative colitis also develop eye-related manifestations of the disease. These may include uveitis, or inflammation of all or part of the uvea (the iris, ciliar body, and choroids); episcleritis, inflammation of the outermost layers of the eye; and keratoconjunctivitis, a condition characterized by dryness of the cornea due to lack of tears. Symptoms of these ocular complications are often headache, abnormal sensitivity to light, blurred vision, burning, and increased secretions from the eyes.

In most cases, when these systemic symptoms occur, they can be effectively treated with standard medications. Only in rare cases is removal of the colon necessary to control severe systemic complications associated with ulcerative colitis.