Digestive Problems When You Have Psoriasis

It may seem odd, but it's true. Psoriasis is related to some digestive disorders that are also autoimmune diseases.

Right now, there isn't anything you can change about your lifestyle to specifically keep you from getting one of these digestive problems that's written into your genes.

Research into the complex relationship is ongoing, and there's a lot more still to be learned. Here's what we know so far.

Psoriasis and IBD

There's a strong link between psoriasis and inflammatory bowel disease, or IBD. IBD includes Crohn's disease and ulcerative colitis (UC). Crohn's can affect any part of the stomach and intestines; UC usually affects the lower parts of your GI tract, the colon and rectum.

After looking at the gene patterns of tens of thousands of people with serious autoimmune diseases, scientists are finding that the same problem genes can be responsible for psoriasis, Crohn's, and UC. These conditions trigger inflammation in similar ways, too.

Your skin and intestines are organs made up of tissue that absorbs things more easily, so it's not surprising that both are sensitive and react to the inflammation signals that travel throughout your body.

One study found that 1 in 10 women with psoriasis develop an IBD. (The odds were even higher for those with psoriatic arthritis, another condition linked with psoriasis.) People with psoriasis are 2.5 times more likely to get Crohn's and 1.6 times more likely to get UC. Some people get a digestive disorder first and psoriasis later.

IBD and psoriasis also share a connection with obesity. Fat tissue seems to make chemicals that change how the body works, including the immune system. Having a lot of extra weight raises your odds of having psoriasis, Crohn's, and UC. It can also make them get worse faster and make treatments less effective.

Psoriasis and Celiac Disease

When you have celiac disease, you can't digest gluten, a protein in wheat, rye, and barley. Celiac disease can damage your small intestine and prevent it from absorbing key nutrients.

The chance of getting celiac disease is nearly 3 times higher among people with psoriasis. About 4 of every 100 have it. Research shows that the higher the levels of specific antibodies related to celiac disease, the worse psoriasis tends to be.

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Spot Symptoms

Watch for signs of digestive issues, and tell your doctor so you can get tested and change your treatment plan, if needed.

IBD (Crohn's disease, ulcerative colitis) symptoms include:

  • Diarrhea
  • Belly cramps
  • Blood in your poop

Celiac disease or gluten sensitivity symptoms in adults may include:

  • Diarrhea
  • Bad-smelling poop
  • Fatigue
  • Feeling weak, dizzy, or short of breath
  • Cold hands and feet
  • Sore, achy joints

You might mistake celiac disease for psoriatic arthritis, because both can cause joint pain and fatigue. Your doctor can order a blood test that measures levels of antibodies to check whether gluten affects you.

Managing Both Conditions

It's often helpful to have a specialist called a gastroenterologist as well as a dermatologist on your health care team. You and your team can decide what treatment is right for you based on what and how severe your symptoms are and the medication side effects you're willing to deal with.

The same drug may work for both your psoriasis and IBD. But some biologic medications are more likely than others to trigger a flare for someone who already has an IBD.

Following a gluten-free diet has helped some people clear their psoriasis lesions as well as manage celiac. What's more, going gluten-free has helped people who test positive for a gluten sensitivity even when they don't have any celiac symptoms or signs of the disease.

Healthy habits -- including a nutritious diet and regular exercise -- can help you feel better, lower your chance of having flares, and get a better result from treatment. Of course, take your medication as directed. Don't smoke, and limit how much alcohol you drink. Find ways to ease stress, maybe by joining a support group.

Let your doctor know about any new or changing symptoms.

WebMD Medical Reference Reviewed by Stephanie S. Gardner, MD on January 24, 2019

Sources

SOURCES:

Psoriasis: Targets and Therapy: "Psoriasis and inflammatory bowel disease: links and risks."

National Psoriasis Foundation: "Comorbidities associated with psoriatic disease," "About psoriatic arthritis."

CDC: "What is inflammatory bowel disease (IBD)?"

Nature Genetics: "Analysis of five chronic inflammatory diseases identifies 27 new associations and highlights disease-specific patterns at shared loci."

Archives of Dermatological Research: "Digestive system in psoriasis: an update."

Journal of the American Academy of Dermatology: "Inflammatory bowel disease among patients with psoriasis treated with ixekizumab: A presentation of adjudicated data from an integrated database of 7 randomized controlled and uncontrolled trials," "Diet and Psoriasis: Part 2. Celiac Disease and Role of a Gluten-Free Diet," "Psoriasis and comorbid diseases: Implications for management."

Autoimmunity Reviews: "Obesity in autoimmune diseases: not a passive bystander."

Celiac Disease Foundation: "What is celiac disease?" "Celiac disease symptoms."

Journal of Dermatological Treatment: "Early intervention in psoriasis and immune-mediated inflammatory diseases: A hypothesis paper," "Interleukin-17 inhibition: role in psoriasis and inflammatory bowel disease."

Mayo Clinic: "Anemia," "Psoriasis."

Arthritis & Rheumatology: "Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2015 Treatment Recommendations for Psoriatic Arthritis."

British Journal of Dermatology: "Paradoxical ulcerative colitis during adalimumab treatment of psoriasis resolved by switch to ustekinumab."

American College of Gastroenterology: "ACG Expert Tips on Living Well with IBD."

Crohn's & Colitis Foundation: "Extraintestinal IBD Complications," Crohn’s Disease and Ulcerative Colitis: Emotional Factors Q & A.

NHS Choices: "Psoriasis: Living with."

Nursing Research and Practice: "Self-Management in Daily Life with Psoriasis: An Integrative Review of Patient Needs for Structured Education."

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