Neurological symptoms and complications of inflammatory bowel disease

Upalna bolest crijeva je kronična upalna bolest koja se javlja u dva osnovna oblika: Crohnova bolest i ulcerozni kolitis. Iako prije svega zahvaća gastrointestinalni trakt, treba je shvatiti kao sistemnu bolest jer mnogi pacijenti razvijaju ekstraintestinalne simptome. Te simptome možemo podijeliti na ekstraintestinalna očitovanja (vjerojatno imunološki posredovana) i ekstraintestinalne komplikacije bolesti (trombofilija ili nedostatak nutrijenata zbog malapsorpcije). Uz to, lijekovi mogu izazvati neurološke nuspojave tijekom liječenja. Neurološka očitovanja i komplikacije upalne bolesti crijeva javljaju se rijetko, no također su često neprepoznate te nedovoljno istraživane, a podatci objavljivani u literaturi oskudni. Najvažniji entiteti među njima su cerebrovaskularne bolesti (moždani udar i cerebralna venska tromboza), centralna demijelinizacija, periferne neuropatije, glavobolje, sindrom nemirnih nogu i senzorineuralna oštećenja sluha. Iako su daljnja istraživanja potrebna kako bismo objasnili povezanost između upalne bolesti crijeva i njenih neuroloških očitovanja i komplikacija, nužno je podizati svijest o njima među liječnicima i pacijentima, učiti kako ih prepoznati te pravovremeno započeti s liječenjem kako bi se izbjegla trajna neurološka oštećenja ili čak fatalni ishodi.Inflammatory bowel disease is a chronic inflammatory disease which appears in two major forms: Crohn's disease and ulcerative colitis. Although it primarily affects the gastrointestinal tract, it should be considered a systemic disease because many patients develop extraintestinal symptoms. Those symptoms can be divided into extraintestinal manifestations of the disease (probably immunologically mediated) and extraintestinal complications (thrombophilia or nutrient deficiency due to malabsorption). Moreover, medications can cause neurological side effects during the treatment. Neurological manifestations and complications of inflammatory bowel disease occur uncommonly, but are also frequently unrecognized and insufficiently investigated and data published in the literature is quite scarce. The most important entities among them are cerebrovascular disease (both cerebral infarction and cerebral venous thrombosis), central demyelination, peripheral neuropathy, headache, restless legs syndrome and sensorineural hearing loss. Although further investigations are needed in order to explain the connection between inflammatory bowel disease and its neurological manifestations and complications, it is necessary to raise awareness on them among physicians and patients, learn how to recognize them and start the treatment on time in order to aviod permanent neurological damage or even fatal outcomes