Sepsis and Inflammatory Bowel Disease (IBD)

Crohn’s disease and ulcerative colitis are two bowel diseases that are classified as inflammatory bowel disease (IBD). IBD is often confused with irritable bowel syndrome (IBS), but they are not the same thing. IBS is a syndrome that describes a group of bowel symptoms, like diarrhea or cramping. It can be very uncomfortable and affect quality of life, but IBS doesn’t cause inflammation or damage to the bowels. IBD, on the other hand, can cause serious inflammation and damage to the bowel walls. Almost 3 million people in the United States have IBD and it is becoming more common, especially among non-Hispanic Black adults. 

Inflammatory bowel disease can lead to complications, such as a perforated bowel wall, that can cause infection and could lead to sepsis.

Sepsis, which was often called blood poisoning, is the body’s life-threatening response to infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment.

Suggested Citation:
Sepsis Alliance. Sepsis and Inflammatory Bowel Disease. 2024.

Updated January 19, 2024.


More About IBD

Infection Risk

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. 

Signs of Infection

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. 

Related Resources

Kim Steele

Who knew a week after Mother’s Day, my life and my family’s life would change forever? On May 14, 2016, I was not feeling well and having difficulty breathing. I have Crohn’s Disease and two small cancer spots were recently found on my colon just a couple of weeks before. I started a new medication just 4 days prior and something shut down my immune system. (Sepsis and Inflammatory Bowel Disease (IBD), Sepsis and Cancer, Sepsis and Impaired Immune System) When my other sisters and mom arrived at Henry Piedmont ER early that morning within an hour, my heart stopped ... Read Full Story

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