Inflammatory bowel disease: thinking outside of the intestines (Part 1).

Inflammatory bowel disease (IBD) can present itself in many different ways. Although it mainly affects the gastrointestinal tract, it can manifest itself practically anywhere else within the body. These extraintestinal manifestations (EMs) can occur both during active disease and when the disease is quiescent, and in some cases can precede the diagnosis of IBD. It is imperative for physicians to recognize the EMs of IBD since some of them can cause significant morbidity and mortality if left untreated. This article will review the EMs of IBD which involve the hepatobiliary, mucocutaneous, musculoskeletal and ophthalmologic systems.