# Extraintestinal manifestations in ulcerative colitis patients with disease phenotype: insights from a Pakistani population

## TL;DR

This study explores how often ulcerative colitis patients in Pakistan experience non-colonic symptoms and finds these are linked to disease severity.

## Contribution

The study provides insights into EIM prevalence and factors in a Pakistani UC population, emphasizing severity associations.

## Key findings

- 36.1% of UC patients had extraintestinal manifestations, with musculoskeletal and hepatobiliary issues being most common.
- Disease severity was significantly associated with EIM presence, while age, gender, and duration were not.
- Ocular and dermatological manifestations were observed in 5.4% and 6.1% of patients, respectively.

## Abstract

Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) involving continuous colonic mucosal inflammation that leads to extraintestinal manifestations (EIMs) in many patients. Understanding the prevalence, patterns and factors associated with EIMs is vital for optimizing UC patient care, making this study essential for assessing EIM frequency, distribution and stratification.

This observational, cross-sectional study was conducted at Jinnah Postgraduate Medical Centre in Karachi from June 2022 to November 2024, involving 147 UC patients. Prospective data collection was used to assess disease severity using the standard criteria. EIMs were classified according to their type. Statistical analysis included descriptive and inferential methods using chi-square tests with p <0.05.

EIMs affected 53 (36.1%) patients, with musculoskeletal manifestations in 13(8.8%) and hepatobiliary issues in 12(8.2%). Ocular involvement was observed in 8(5.4%) patients, dermatological manifestations in 09 (6.1%), renal issues (nephrolithiasis) in 5(3.4%) and systemic problems in 6(4.1%). Gender, age and disease duration did not significantly correlate with the presence of EIM (p >0.05), but severity showed a significant association (p<0.05).

Extra-intestinal manifestations, especially musculoskeletal and hepatobiliary manifestations, are commonly found in ulcerative colitis. EIMs are correlated with disease severity and are not related to gender and age.