Urology

Urinary Tract Infections

Also called “bladder infections” or “cystitis,” Urinary tract infections (UTIs) occur when bacteria enter the bladder, usually through the urethra (urine tube) and begin to multiply. Urine contains fluids, salts and waste products but is sterile or free of bacteria, viruses and other disease-causing organisms. A UTI occurs when bacteria from another source, such as the nearby anus, gets into the urethra. The most common bacteria found to cause UTIs is Escherichia coli (E. coli).

UTIs are a common medical complaint. It is estimated that up to 40 percent of all women will have a UTI at some time in her life. Bladder infections are most common in young women with 10% of women getting an infection yearly.

E. coli normally lives harmlessly in the human intestinal tract but it can cause serious infections if it gets into the urinary tract. In women, the trip from the anus to the urethra is a short one. This is the reason why “wiping front to back” after using the toilet is helpful in preventing UTI. Other bacteria can cause UTI, but E. coli is the culprit about 90 percent of the time. An untreated UTI can move up to the kidneys and cause an even more serious infection, so prompt diagnosis and treatment is important. Sexually active women, pregnant women and older women all may be at increased risk for UTI.

The symptoms of UTI can include:

  • Pain or burning with urination
  • Lower abdominal pain or pressure
  • The need to urinate frequently
  • The urine may look cloudy or darker in color or it may appear bloody

However, some women, especially older women, may have very subtle or no symptoms. If you experience a sudden increase in the need to urinate often, or start to leak urine involuntarily — a condition called urinary incontinence — especially if this is a new problem, UTI could be the cause.

A fever, flank pain, nausea or vomiting accompanying any of these symptoms could signal that the infection has reached the kidneys, and you should seek immediate medical attention.

For an uncomplicated UTI, a three- to seven-day course of antibiotics will provide rapid relief. You may also receive a prescription for pyridium, a medication that eases bladder pain while the antibiotic is taking effect. For recurrent or more serious infections, treatment may be extended to 10 to 14 days.

For patients with four or more infections a year, the following measures may reduce the incidence of urinary tract infections:

  • Cranberry juice or capsules
  • A prolonged course (six months to a year) of low-dose antibiotics
  • For post-menopausal women intravaginal application of topical estrogen cream

Urethral Injuries

The urethra is a tube that connects the bladder to the genitals to remove urine out of the body.

If the urethra is injured, a person may develop urethra obstructions or strictures. Urethral strictures occur when the urethra is injured or scarred by an infection and then narrows. As a result, problems with the normal passage of urine and semen can develop.

Urethral injuries can result in devastating long term consequences. To a young person, the potential complications of impotence, stricture and incontinence often create life-long morbidity.

Injuries affect two parts of the urethra: either the anterior or posterior. In most cases, anterior urethral trauma is characterized as a blunt injury to the perineum, since the urethra is located near the skin in this area. This type of trauma is often the result of straddle-like injuries, such as when a child forcefully straddles a bicycle or fence. Penetrating injuries to the anterior urethra, such as those from a gunshot wound, also may cause strictures or obstructions.

Posterior urethral trauma affects the part of the urethra that travels inside the body. In many cases, this type of trauma almost always occurs as a result of pelvic fractures following automobile accidents, serious falls or industrial crash injuries.

Patients with urethral injuries may experience a variety of symptoms, including:

  • Weak or slow urine stream
  • Dribbling
  • Urinary frequency
  • Urgency to urinate
  • Nocturia, a condition in which a person has to urinate frequently during the nighttime
  • Urinary retention

Management and treatment of urethral injuries can be complex and depends on the severity and location of injury, the patient’s health and whether any other injuries are present. In some cases, emergency surgical repair is recommended, but should be limited to select cases.

Initial suprapubic cystostomy, which involves placing a catheter in the bladder through the lower abdomen, is the safest and simplest treatment option.

Once the urethra has begun to heal, your doctor will reassess your injury and develop a definitive treatment plan. Reconstructive surgery or the placement of a urethral or suprapubic catheter, which is a tube inserted into the bladder to help drain urine, may be recommended.

Male Sexual Function

Male sexual function disorders are common among men of all ages, ethnicities, and cultural backgrounds.

Some of the disorders that can occur include:

Peyronie’s Disease

Peyronie’s disease is caused by the formation of dense, fibrous scar tissue, or plaque, in the penis’ tunica albuginea — the sheath that surrounds the erectile tissue.

Peyronie’s disease affects about 3 percent of men middle-age and older. Although it can affect men of any race and age, it is most commonly seen in Caucasian males above the age of 40, especially those of blood type A+.

The cause of Peyronie’s disease is not completely known. However, factors such as genetics and trauma to the penis, which may occur due to injury or invasive penile procedures, may contribute to the disease.

Due to the formation of scar tissue in the penis, patients with Peyronie’s disease may experience pain and a curvature or distortion, such as a shortening or narrowing of the penis during an erection. In severe cases, these symptoms may lead to erectile dysfunction.

In about 15 percent of cases, Peyronie’s disease spontaneously resolves itself without treatment. However, more than 40 percent of cases may worsen. If treatment is necessary, oral medications, injections, iontophoresis (painless current of electricity delivers and agent under the skin into the plaque), or surgery may be used. Therapy for the condition aims to relieve symptoms and preserve erectile function.

Surgery has been shown to be the most effective treatment for Peyronie’s disease to correct the curvature of the penis. However, it is usually only recommended in severe cases for patients who fail to respond to non-surgical therapy and have curvature for longer than 12 months.

Priapism

Priapism is an uncommon condition that causes a prolonged and often painful erection, which occurs without sexual stimulation.

In a third of the cases, the cause is unknown. The remaining cases are caused by an associated condition, including:

Priapism is classified into two types — ischemic (no-flow) or non-ischemic (high-flow).

  • Ischemic Priapism — This is the most common form of priapism and usually occurs with several hours or days of a painful erection. It is caused by an obstruction in the penis’ venous drainage, which results in a buildup of poorly oxygenated blood in the corpora cavernosa, the tissue that forms the bulk of the erectile body of the penis.Ischemic priapism is considered a medical emergency and requires immediate treatment. If left untreated, the condition can significantly damage erectile function, by causing extensive scar tissue build-up and impotence.In the early stages of ischemic priapism, a cold shower or ice pack may relieve symptoms. Exercise in the form of climbing stairs also may help. Medications, such as analgesics and opiates to control pain, may be recommended as well. Other treatments for the condition include intracavernous drug therapy and shunt surgery.
  • Non-ischemic Priapism — This type of priapism is not as common or painful. It is usually caused by an injury to the penis or perineum-the area between the scrotum and anus. The injury causes the artery within the erectile body to rupture and thus pumping large amount of blood to the penis continuously.This condition does not require urgent treatment and in some cases, the condition may resolve itself spontaneously after days or months, at which point erectile capacity returns to normal. In some instances where treatment is necessary, ebolization or surgical ligation (tying off the ruptured artery) may be recommended.

Treatment for all forms of priapism aims to eliminate the erection and pain and preserve normal erectile function. Doctors recommend that anyone experiencing an erection lasting four hours should seek medical evaluation and treatment.

Genitourinary Tract Injuries

The genitourinary system (or urogenital system) is the organ system of the urinary system and the reproductive organs. These are grouped together because of their proximity to each other and the use of common pathways, like the male urethra.

About 10 percent of all injuries seen in the emergency room involve the genitourinary tract, including the kidneys, bladder, genitals, ureters and urethra.

Symptoms of genitourinary injury differ depending on the location of the trauma. Some common symptoms may include:

  • Inability to urinate
  • Hematuria, a condition in which blood is present in the urine
  • Lower rib fractures
  • Fractures to the pelvic bone
  • Pain and/or bruising involving a person’s side, groin or scrotum

Treatment of genitourinary injuries depends on a number of factors, including the severity, location and type of injury, the patient’s health and whether the patient has any other injuries.

Before a definitive treatment plan is developed, short-term management may be performed. Short-term management may include:

  • Urethral Catheter — A tube is placed into the bladder through the urethra to drain urine.
  • Suprapubic Catheter — A tube is placed through the abdominal wall into the bladder to drain urine.
  • Nephrostomy Tube — A tube is placed through the patient’s flank (side) to drain urine directly from the kidney.
  • Ureteral Stent — A temporary tube is placed through the ureter to connect the kidney to the bladder.

Kidney Injuries

Treatment for kidney injuries depends on the type and severity of the injury, and whether the patient has any other injuries.

  • Blunt Injuries — In 85 percent of cases, injuries to the kidneys are minor, caused by a blunt trauma and do not require surgery. Treatment aims to stop any bleeding from the kidney. Hospital admission, bed rest and hydration are required until bleeding from the kidney stops and urine is clear.
  • Penetrating Injuries — Surgery is more likely for penetrating injuries, such as those from a gunshot wound, which can cause serious bleeding from the kidney. Surgery aims to repair and preserve the injured kidneys. However, if the kidney is severely injured and beyond repair, surgical removal may be required.

Ureteral Injuries

Injuries to the ureters — the tubes that connect each kidney to the bladder — are rare and usually occur during a difficult pelvic surgical procedure or from a gunshot wound. Treatment depends on the type and severity of injury.

  • Complete Disruption — Ureteral injuries that cause complete disruption (the ureter is torn into two pieces) require emergency surgical repair. The best outcome for surgical repair is prompt treatment at the time of injury.
  • Partial Injuries — Partial ureteral injuries, such as those that occur during a pelvic operation, often can be managed by a ureteral stent. Ureteral stents are thin tubes, called catheters, which are inserted into parts of the ureter that carry urine, produced by the kidney, either down into the bladder, or to an external collection system.Ureteral stenting may be placed on a long-term basis, ranging from months to years, to bypass ureteral obstruction. Short-term stenting, ranging from weeks to months, may be placed during an open surgical procedure of the urinary tract to provide a mold around which healing can occur, or to divert the urinary flow away from areas of leakage.

Bladder Injuries

Bladder injuries are most often caused by an accident, such as a car accident, serious fall or a heavy object falling on the lower abdomen. Treatment depends on the type of injury.

  • Contusion Injury — In these types of injuries, the bladder wall is only bruised and does not rupture. Contusion injuries can be managed with a urethral catheter, which is a tube inserted into the bladder through the urethra, so that blood clots pass. Once the urine is clear and the patient stable, the catheter is removed.
  • Extraperitoneal Rupture — These types of injuries can be managed with a urethral catheter to keep the bladder empty and allow the urine and blood to drain out into a collection bag. In most instances, a patient will heal within 10 days. However, large blood clots in the bladder or injuries involving the bladder neck require surgical repair.
  • Intraperitoneal Rupture — These ruptures require surgical repair to prevent urine from leaking into the abdomen. The repair is performed by making an incision in the abdomen and then sewing the tear closed. A catheter is left in the bladder for a few days to rest the bladder after surgery.
  • Penetrating Injuries — Penetrating injuries usually require surgical repair of any holes made in the bladder. In most instances, surrounding organs are injured and also require repair. A catheter is left in the bladder to drain the urine and blood as described above.

Penile Injuries

Penile injuries can occur in various ways. Some penile injuries include:

  • Penile fractures that occur during sexual intercourse. These are usually surgically repaired.
  • Placing obstructing rings around the base of the penis may lead to gangrene and urethral injuries. The obstructing objects can be removed without further damage.
  • Machinery accidents may cause damage to penile skin, which can be repaired by skin grafting.

Penile injuries often occur with urethral injuries. Therefore, when making a diagnosis of penile injuries, an urethrography — a test involving X-rays of the urethra — will be performed to identify any injuries or obstructions in this area.

Testicular Injuries

Testicular injuries often occur due to a traumatic blow to the groin or scrotum, which can cause severe pain, nausea, vomiting and in some instances, lower abdominal tenderness.

In these cases, a testicular ultrasound — a non-invasive test that uses high-frequency sound waves to create images of the testicles and other parts inside the scrotum — is usually performed to evaluate possible damage to the testicle.

If a testicular fracture is diagnosed, surgical exploration and repair is required.

Erectile Dysfunction

Erectile dysfunction (ED), also known as impotence, is defined as a man’s inability to achieve and maintain an erection that is sufficient for satisfactory sexual intercourse. The ability to have an erection requires the normal, integrative functions of the nerves, blood vessels, muscles and brain.

ED is a common condition affecting an estimated 20 to 30 million men in North America and over 150 million men worldwide.

The greatest medical risk factors for erectile dysfunction include:

  • Diabetes mellitus
  • Heart disease
  • Hypertension
  • Having a decreased high-density lipoprotein level
  • Radiation therapy and surgery for prostate or bladder cancer

ED may result from a variety of factors or a combination of factors. These may include:

  • Psychological causes, such as performance anxiety, a strained relationship, lack of sexual arousability and mental health disorders, including depression and schizophrenia.
  • Neurological disorders, including Parkinson’s disease, Alzheimer’s disease, stroke and brain trauma. These conditions often cause erectile dysfunction by decreasing libido or preventing the initiation of an erection.
  • Hormonal disorders, such as hyperprolactinemia and androgen deficiency, which can decrease nocturnal erections and libido.
  • Vascular conditions and factors, including heart disease, hypertension, hyperlipidemia, cigarette smoking, diabetes mellitus and pelvic irradiation. A disorder called, veno-occlusive dysfunction, in which the veins are unable to close during an erection, also can cause erectile dysfunction.
  • Certain medical drugs, such as antipsychotic, antidepressant and centrally acting antihypertensive drugs, may disturb the pathways involved in sexual function. Other drugs known to cause erectile dysfunction include Cimetidine, a histamine H2-receptor antagonist, estrogens and drugs with antiandrogenic action, such as ketoconazole and cyproterone acetate.
  • Smoking cigarettes
  • Drinking large amounts of alcohol, as well as suffering from chronic alcoholism, also can cause erectile dysfunction.
  • Other factors, such as old age and chronic renal failure, can also contribute to erectile dysfunction.

The hallmark symptom of erectile dysfunction is the inability to achieve and maintain an erection for satisfactory sexual intercourse. This condition also may involve problems with emission, ejaculation and orgasm.

It is important to note that it is not necessary to have an erection to have an orgasm. A vibrator or creative and attentive partner can be helpful.

There are a variety of treatment options available for erectile dysfunction, which will be explained to you by your doctor. Your therapy will depend on the cause of ED, your age, your health and you and your doctor’s preferences.

Treatments include:

  • Oral medication, such as Viagra, Levitra or Cialis
  • Urethral suppository (MUSE) — uses a small suppository of medication that is placed in the penile uretha without needles. The suppository is then absorbed and helps to produce an erection.
  • Penile injections
  • Vacuum device
  • Microvascular surgery — for patients who have blood vessel blockage or leakage
  • Penile prosthesis — for men who do not tolerate or respond to other treatments
  • Penile Vascular Reconstructive Surgery — recommended only for young men who have ED as result of congenital or traumatic venous leakage of the penis

Bladder Control

Incontinence is a problem that can be cured or controlled with treatment. Bladder control conditions include:

  • Pelvic floor support problems or prolapse
  • Overactive bladder or urge incontinence
  • Stress incontinence
  • Mixed incontinence

Nearly 85 percent of North Americans with incontinence are women, but many don’t seek help. About 25 percent of women in their reproductive years and 50 percent of women in postmenopausal years experience the condition.

Prolapse

If you have an uncomfortable feeling of bulging, drooping, or pressure in your vagina, you may have a condition called prolapse or pelvic support problems. This occurs when the tissues that support the pelvic organs are damaged or stretched allowing the organ to drop down out of normal position and causing a bulge. Women with prolapsed pelvic organs may have a feeling of pelvic pressure or heaviness in the pelvic region. Sometimes it feels as if something is “falling out.” Prolapse also may cause incontinence.

Childbirth and aging are the two most common causes of this condition. During childbirth, the tissues of the pelvic organs may be damaged or weakened due to the stretching that can occur. As a result, these tissues may not provide as much support for the organs as necessary. Symptoms may worsen after menopause.

The main types of pelvic support problems include:

  1. Cystocele, when the bladder is not supported properly.
  2. Enterocele, when the small intestine is not supported properly.
  3. Rectocele, when the rectum is not supported properly.
  4. Uterine prolapse, when the uterus is not supported properly.
  5. Vaginal prolapse, when the vagina is not supported properly.

The risk of developing prolapse is increased with:

  • Smoking
  • Obesity
  • Connective tissue disorders
  • Upper respiratory disorders
  • Repetitive strain injuries

Minor prolapse can be treated with exercises (Kegels) to strengthen the pelvic floor muscles; more serious prolapse requires vaginal inserts or reconstructive surgical treatment.

Surgery typically includes repair of tears in the fascia — a sheet of connective tissue that covers or binds structures in the body — or suspension of the prolapsed tissues to stronger structures in the pelvis. In some cases, a graft may be used to help strengthen the area. The surgery may be performed through a vaginal or abdominal incision or a combination of both.

Stress Incontinence

Stress Incontinence is a condition resulting from an increase in pressure in the abdomen that increases physical stress on the pelvis causing urine leakage. It is due to insufficient strength of the pelvic floor muscles. Coughing, sneezing, laughing, exercise and even standing up are activities that can cause leakage in women with this type of incontinence.

In women, physical changes resulting from pregnancy, childbirth, and menopause often contribute to stress incontinence. Stress incontinence can worsen during the week before the menstrual period due to lowered estrogen levels, which may lead to lower muscular pressure around the urethra, increasing chances of leakage.

Behavioral changes as a form of treatment include:

  • Weight loss
  • Exercise (Kegels)
  • Decrease the amount of liquid that you are ingesting
  • Avoid drinking caffeinated or carbonated beverages and alcohol
  • Avoid spicy foods and citrus
  • Quitting smoking

Other treatments include:

  • Biofeedback – Biofeedback therapy uses computer graphs and audible tones to show you the muscles you are exercising
  • The knack – Learning to use the pelvic muscles at the right time to stop leaks
  • Vaginal inserts and pessaries – used to treat bladder and pelvic support problems
  • Electrical Stimulation – uses low-grade electrical current to stimulate weak or inactive pelvic muscles to contract
  • Surgery – bladder neck suspension procedures and sling procedures
  • Medications – Estrogen replacement therapy

Overactive Bladder or Urge Incontinence

If you leak urine and have sudden, strong urges to urinate or if you urinate excessively, you may have urge incontinence or overactive bladder. This urge and the spasm of the bladder muscles may occur at any time, regardless of the amount of urine in the bladder.

In many women, there is no known cause. In some cases, the condition is caused by:

  • Neurological injuries such as spinal cord injury or stroke
  • Neurological diseases such as multiple sclerosis
  • Bladder stones, cancer, infection and inflammation
  • Damage to the bladder muscles caused by childbirth, hysterectomy or injury

The main symptom is loss of urine associated with a sudden, strong desire to urinate that cannot be postponed. Women may describe mounting pressure or sudden loss of urine in a rush to reach the toilet. Often, this occurs with certain triggering events, such as fumbling with the keys to open the front door, the sound or sensation of running water on the hands, or exposure to sudden cold. Other symptoms include a need to urinate frequently and waking often during the night to urinate.

Treatment for urge incontinence may include behavioral treatments such as pelvic muscle exercises, bladder training, urge suppression, medication, electrical stimulation, or Botox injections.

Mixed Incontinence

It is quite common for a woman to experience a combination of both “stress” incontinence and “overactive bladder” symptoms.

  • Overactive Bladder – If you leak urine and have sudden, strong urges to urinate or if you urinate excessively, you may have urge incontinence or overactive bladder.
  • Stress Incontinence – This is a condition resulting from an increase in pressure in the abdomen that causes physical stress on the pelvis and urine leakage. Coughing, sneezing, laughing, exercise and even standing up are activities that can cause leakage in women with this type of incontinence.

Treatment for mixed incontinence can include combinations of therapies prescribed for either stress or urge related incontinence (see above).

Urologic Cancer

Urologic cancers include cancers of the bladder, kidney, prostate and testicles, all relatively common. Prostate cancer, for example, is the most common cancer in North American men. One out of every 10 men will develop the disease at some time in his life — most often after age 50.

Bladder Cancer

Bladder cancer is the fourth most common cancer among men and the ninth most common among women in North America. Each year, more than 50,000 new cases of bladder cancer are diagnosed.

The wall of the bladder is lined with cells called transitional cells and squamous cells. More than 90 percent of bladder cancers begin in the transitional cells. This type of bladder cancer is called transitional cell carcinoma. About 8 percent of bladder cancer patients have squamous cell carcinomas.

Cancer only in cells in the lining of the bladder is called superficial bladder cancer. This type of bladder cancer often comes back after treatment, but it does not tend to progress. If the tumor recurs, the disease often recurs as another superficial cancer in the bladder. Cancer that begins as a superficial tumor may grow through the lining and into the muscular wall of the bladder. This is known as invasive cancer. Invasive cancer may extend through the bladder wall. It may grow into a nearby organ such as the uterus or vagina in women or the prostate gland in men. It also may spread to other parts of the body.

When bladder cancer spreads outside the bladder, cancer cells are often found in nearby lymph nodes. If the cancer has reached these nodes, cancer cells may have spread to other lymph nodes or other organs, such as the lungs, liver or bones.

When cancer spreads or metastasizes from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if bladder cancer spreads to the lungs, the cancer cells in the lungs are actually bladder cancer cells. The disease is metastatic bladder cancer, not lung cancer. It is treated as bladder cancer, not as lung cancer. Doctors sometimes call the new tumor “distant” disease.

Fortunately, the majority of bladder cancers do not grow rapidly and can be treated without major surgery. Thus, most patients with bladder cancer are not at risk of developing a cancer that will spread and become life threatening. Early detection is vital; it allows the prompt treatment that gives patients the best chance for a favorable outlook.

Common symptoms of bladder cancer include:

  • Blood in the urine, making the urine slightly rusty to deep red
  • Pain during urination
  • Frequent urination, or feeling the need to urinate without results

These symptoms are not sure signs of bladder cancer. Infections, benign tumors, bladder stones or other problems also can cause these symptoms.

Treatments include:

  • Cystectomy — tumors can be “shaved off” using an electrocautery device attached to a cystoscope
  • Immunotherapy
  • Chemotherapy
  • Thermo-chemotherapy — uses radio-frequency energy to directly heat the bladder wall
  • Radiation

Kidney Cancer

In its early stages, kidney cancer usually causes no obvious signs or troublesome symptoms. As a kidney tumor grows, symptoms may occur. These may include:

  • Blood in the urine. In some cases, blood is visible. In other instances, traces of blood are detected in a urinalysis, a lab test often performed as part of a regular medical checkup.
  • A lump or mass in the kidney area.

Other less common symptoms may include:

  • Fatigue
  • Loss of appetite
  • Weight loss
  • Recurrent fevers
  • Pain in the side that doesn’t go away
  • General feeling of poor health
  • High blood pressure or a lower than normal number of red cells in the blood (anemia) may also signal a kidney tumor. These symptoms occur less often.

Treatment for kidney cancer depends on the type and stage of the disease. Treatments can include chemotherapy, radiotherapy and/or nephrectomy.

Spondyloarthritis

Spondyloarthritis is a group of diseases that cause inflammation of the spine, joints, tendons, ligaments and surrounding areas. These conditions also can affect the eyes, gut, urinary tract, skin and sometimes the heart and lungs. Spondyloarthritis includes:

  • Ankylosing spondylitis
  • Reactive arthritis
  • Psoriatic arthritis
  • Arthritis of inflammatory bowel disease

Spondyloarthritis tends to impact those in their teens and 20s, and young men two to three times more frequently than young women. In some cases, these diseases are genetic and associated with the gene HLA-B27. They can affect every ethnic group, although they are less common in African Americans who have a lower frequency of HLA-B27. Spondyloarthritis may occur in as many as 13 percent of people with HLA-B27.

While there is no course of prevention at this time, treatment can reduce discomfort and delay the development of spinal deformities. Nonsteroidal Anti-inflammatory Drugs (NSAIDS) offer considerable symptom relief. A regular regimen of recreational activities and back exercises will improve comfort levels.

Reactive Arthritis

Reactive arthritis, formerly called Reiter’s Syndrome, typically occurs as a reaction to an infection somewhere else in the body, usually the bowel or urogenital tract. Chlamydia trachomatis is the bacteria most commonly associated with reactive arthritis of the urogenital tract. Eating foods or substances contaminated by bacteria, such as salmonella, shigella, campylobacter and yersinia, can cause intestinal reactive arthritis. In many patients, the infection is not obvious.

General symptoms of reactive arthritis usually begin about one to three weeks after an infection. The initial symptoms include joint pain and swelling, skin rashes, mouth sores, redness of the eyes, fever and weight loss. Symptoms may come and go, and may be so mild that patients do not notice them.

Arthritis of Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a group of disorders, including Crohn’s Disease and Ulcerative Colitis, that cause an inflammation of the intestines. Approximately 7 percent to 20 percent of people with IBD develop arthritis, which typically affects the large joints of the lower extremities. Men and women with IBD are affected by arthritis equally. Symptoms of arthritis usually occur at the same time a person is experiencing symptoms of IBD.

If you are suffering from any of the symptoms listed above, consult a physician as soon as you can.