Bowel Disease, Nerve Problems Linked

ByABC News

Mar. 23 --

MONDAY, April 23 (HealthDay News) -- People with inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, are at especially high risk for carpal tunnel syndrome and other nerve ailments, a new study finds.

"We found that those with inflammatory bowel disease were more than six times more likely to also have a disorder called sensorimotor polyneuropathy, a nerve disease that can cause weakness, pain, and numbness," said Dr. Francisco De Assis Gondim, professor of neurology at the Federal University of Ceara in Brazil.

"Those with bowel disease were also four times more likely to develop symptoms in the spectrum of a nerve disease called small fiber neuropathy, which causes pain and lack of feeling in the feet," he added. People with IBD were also four times as likely to develop carpal tunnel syndrome compared to individuals without the bowel ailment.

All of these conditions were "more common in women with bowel disease than in men," Gondim added.

The findings were expected to be presented at this week's annual meeting of the American Academy of Neurology, in Boston.

IBD affects more than 600,000 Americans, according to the American Academy of Family Physicians. The name applies to a group of disorders, including Crohn's disease and ulcerative colitis, in which the intestines are inflamed. Symptoms can include abdominal cramps and pain, weight loss, diarrhea and bleeding from the intestine.

In the study, the researchers compared 103 people with Crohn's disease and ulcerative colitis to 51 people with other digestive disorders, including chronic heartburn, gastritis and irritable bowel syndrome.

Irritable bowel syndrome affects mainly the large intestine and causes constipation, diarrhea, or both at different times.

Gondim's team gave everyone a standard neurological evaluation, including testing for nerve problems.

They discovered that people with IBD were much more likely to develop a variety of nerve conditions compared to people in other groups.

The exact link between bowel and nerve disorders remains unclear.

"This should be analyzed carefully, because in many patients, I could diagnose other medical conditions which could have at least contributed to the development of nerve damage, like diabetes, glucose intolerance, vitamin deficiencies, hypothyroidism," Gondim said. But, "in many patients, we have no explanation (other than IBD), which may suggest that there is an undiagnosed nutritional deficiency or ongoing immune-mediated nerve damage."

It's not known yet, Gondim said, how all these factors may interact to affect the course of the IBD.

Another expert called the research "an important study." Dr. Dawn Eliashiv, director of neurophysiology at Cedars-Sinai Medical Center, Los Angeles, said the finding "exemplified the fact that when we are dealing with patients, we cannot overlook that GI disorders affect many systems."

"Patients with IBD may have vitamin B12 deficiency or vitamin E deficiency," Eliashiv noted, "which may cause numbness, instability of gait or balance problems."

Hopefully, the study will raise awareness among physicians about the possibility of neurological complications occurring alongside IBD, she said.

Eliashiv and Gondim agreed on their advice to those with IBD: Anyone with the condition who also has numbness or pain in the hands or feet should seek medical attention. If they have balance problems or weakness, they also need to consult their doctor.

The study was supported by grants from the Federal University of Ceara and the Brazilian Ministry of Health.

More information

To learn more about IBD, visit the American Academy of Family Physicians.

SOURCES: Francisco De Assis Gondim M.D., Ph.D., professor, neurology, Federal University of Ceara, Brazil; Dawn Eliashiv, M.D., director, neurophysiology, Cedars-Sinai Medical Center, Los Angeles; April 23, 2007, presentation, annual meeting, American Academy of Neurology, Boston

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