Today I want to talk about how Crohn’s Disease can manifest in women’s genitalia and what complications could possibly arise if/when a woman is struck with symptoms in that area. This topic is not talked about enough, but so many woman struggle with it. This is a second part to a series I’m writing about women’s health in IBD; here’s part 1.
Some of the complications women can deal with include:
Enteric Fistulas – These can occur in the rectum, ileum, proximal colon. Often times, the diagnosis can remain unclear and infections, as well as symptoms, can become refractory to treatment – this can be a clue that an Enteric Fistula is present. Some of these symptoms include suprapubic pain and increased urination, as well as pain while voiding, pneumaturia, or passing of “air” in the urine. 1
Vulvar inflammation – In the next article of our series, I will delve specifically into the anatomy of Crohn’s of the Vulva, but I want to briefly address it here. In Crohn’s of the vulva, patients experience painful inflammation with some physical evidence of infections such as swelling, discharge of ulcers on the labia minora and labia majora. Often, these cysts and abscesses may need further investigation. There has been data that shows certain drugs like anti-TNFs, and cytokine-targeting therapies aid in the healing of refractory enterocutaneous fistulas. 1
Vaginal Granulomas – This complication can actually be difficult to diagnose, as it can present with signs and symptoms of inflammation with or without the presence of fistulas/abscesses. Because of this, symptoms involving the reproductive organs can easily be misdiagnosed because of the lack of information about the gynecologic involvement of Crohn’s Disease.1
It is important that you have a gynecologist that you trust as part of your care team. I see a gynecologist that specializes in high-risk situations and is familiar with Crohn’s Disease, which makes bringing up my issues with both my GI and my OB easier and less humiliating. When you first begin to experience issues that affect your reproductive organs and as well as your gastrointestinal tract, it can be very difficult to bring these symptoms up to a care provider.
Know that this is the best thing you can do before your symptoms worsen or infections develop. Ask your GI if he/she has any recommendations for a gynecologist that can help be the go-between for you and your GI. They have both played a crucial role in the care of my complications in the last year, as we determine my course of action.
Stay tuned for the next article in this series of Women’s Health in IBD, as I talk about Crohn’s Disease of the Vulva.