When IBD affects more than your gut.
How IBD can affect parts of your body beyond the gut, and what you can do about it.
Lesson 5 of 5
3 min read · Updated September 16, 2026 · Medically reviewed by Shamita Shah, MD
In this lesson
Key takeaways
- 25 to 40 percent of people with IBD have inflammation outside the gut, most often in the joints, skin, eyes or liver.
- Joint pain is common and often improves when your IBD is treated.
- Check with your doctor before taking NSAIDs like ibuprofen or aspirin.
- Tell your care team about fatigue. Simple tests can find treatable causes like anemia.
What are extraintestinal manifestations?
Extraintestinal manifestations, or EIMs, are inflammation problems that show up outside your gut when you have IBD. “Extraintestinal” simply means “outside the intestines.” EIMs most often affect the joints, skin, eyes or liver, though other organs can be involved.
Research shows that 25 to 40 percent of people with IBD develop at least one EIM, and that number can climb to about 50 percent within the first 30 years after diagnosis. Telling your care team about any new symptom outside your gut helps catch EIMs early, before they cause lasting harm.
Joint pain and arthritis
Joint pain is one of the most common problems linked to IBD, affecting up to 30 percent of people with Crohn’s disease or ulcerative colitis. Peripheral arthritis affects large joints in your arms and legs, like your elbows, wrists, knees and ankles. It often shows up alongside a gut flare and usually improves once your IBD is treated, without causing lasting joint damage.
One important caution: NSAIDs (nonsteroidal anti-inflammatory drugs), like ibuprofen and aspirin, are common over-the-counter pain relievers, but they can irritate your gut lining and make IBD symptoms worse. Always check with your doctor before using them for joint pain.
Fatigue
Fatigue, feeling worn out even after resting, is one of the most common complaints among people with IBD. It affects nearly 80 percent of people during an active flare, and about half of people even when their disease is in remission and symptoms are quiet.
One common, treatable cause is anemia, a condition where you don’t have enough healthy red blood cells to carry oxygen through your body. Because fatigue has so many possible causes, tell your care team about it. Simple tests, like a blood count, can uncover treatable reasons behind your exhaustion.
Symptoms outside your gut are a real part of IBD, and your care team can help manage them right alongside your digestive symptoms.
Questions to ask at your next visit
- Could my joint, skin or eye symptoms be related to my IBD?
- Which pain relievers are safe for me to take?
- Should I get a blood test to check for anemia?
- Should I see other specialists, like an eye doctor or a dermatologist?
Who to call
Medical emergency
Call 911 or go to the nearest emergency room.
Symptoms or medicine questions
Contact your GI doctor’s office.
Questions about SonarMD
Call a care coordinator at 312-283-0601, Monday–Friday, 8 a.m.–5 p.m. CT.
This information is for education only and does not replace advice from your doctor. If you have severe symptoms, contact your doctor right away. In an emergency, call 911.