Sepsis and Inflammatory Bowel Disease (IBD)

Crohn’s disease and ulcerative colitis can cause several complications, such as: 

• Colon cancer 
• Blood clots 
• Anemia 
• Kidney stones 
• Liver disease 
• Malnutrition 
• Perforated bowel 
• Anal fistulas (a tunnel between the anus and the anal gland) 
• Toxic megacolon 

Several of these complications, like a perforated bowel and kidney stones, can cause infections. Others, like malnutrition and cancer, can increase the risk of getting infections. 

People with IBD can also be at higher risk of contracting infections because of their treatment. Many with IBD take medications, such as steroids, to help suppress the inflammation in the bowel. But those medications also suppress the immune system, raising the infection risk. 

Surgery may be necessary to repair a damaged part of the bowel, relieve an obstruction, or create a colostomy. There is always a risk of infection with any type of surgery, especially abdominal surgery, when a surgeon could unknowingly nick the bowel wall. Abscesses can also form after the surgery. 

Although both Crohn’s disease and ulcerative colitis are IBD, the conditions respond differently to sepsis, according to researchers. 

In one study published in 2017, researchers found that IBD patients who were hospitalized for severe sepsis or septic shock had different outcomes. Those with Crohn’s disease had a lower mortality rate (less than 20%) compared with those with ulcerative colitis (35%). However, it is still very serious regardless of which disease you may have. 

In some cases, people may not know they have IBD and develop an infection that causes sepsis. In those cases, the doctors find evidence of IBD while trying to find the sepsis cause. 

People with inflammatory bowel disease should watch for signs of infection and seek help immediately if they suspect one. Some signs and symptoms of an infection related to the bowel include: 

• Severe pain in the abdomen 
• Fever 
• Chills 
• Nausea 
• Vomiting 
• Bloating/swelling of the abdomen 
• Pain and swelling around the anus 
• Redness, swelling, or pus coming from around the anus 

Infections in other parts of the body can cause other symptoms, such as: 

• New or increasing cough (pneumonia or other respiratory infection) 
• Redness, swelling, or discharge around a wound 
• Increased need to urinate, burning on urination, foul smelling urine (UTI) 

If you or someone you care for has IBD, ask your doctor what you should do if you suspect there is an infection. Some clinics or offices have after-hour staff that can help, while others may direct you to go to an emergency department or urgent care clinic.