What You Should Know About the Connection Between Psoriasis and IBD

Psoriasis and IBD are related conditions that both involve malfunctioning immune systems and chronic inflammation. People with psoriasis are at increased risk of developing Crohn’s disease and ulcerative colitis.

Researchers believe that there’s a connection between psoriasis and inflammatory bowel disease (IBD). People with psoriasis are at an increased risk of IBD. Psoriasis and IBD are both immune-related conditions that cause inflammation.

Psoriasis is a chronic disease caused by a dysfunction in the immune system. It causes inflammation throughout the body, most notably on the skin. The most common type of psoriasis, plaque psoriasis, causes skin cells to grow more quickly than they should, causing them to pile up and form raised, scaly patches of skin.

Inflammatory bowel disease (IBD) is another immune-related condition that causes inflammation in the body, primarily in the intestines and bowels. The most common forms of IBD are ulcerative colitis (UC) and Crohn’s disease.

Research shows that there’s a clear connection between psoriasis and IBD. People with psoriasis are more likely than others to develop both Crohn’s disease and ulcerative colitis. But the exact nature of the connection between these two conditions is still unknown.

Researchers are exploring potential genetic links between the two conditions. Other potential factors that may increase your risk of psoriasis and IBD include:

• immune system issues
• chronic inflammation
• microbiome
• genetic predisposition
• environmental factors

Generally, people with psoriasis are prone to co-occurring conditions, in addition to IBD. People with psoriasis are at increased risk of:

• heart diseases
• kidney disease
• uveitis
• mental health issues
• metabolic syndrome

The role of the gut

Some researchers have also pointed out that psoriasis often seems to occur with a variety of digestive system issues.

A 2018 review of studies with a total of over 1.8 million people found that people with psoriasis are 2.5 times more likely than people without psoriasis to also experience symptoms of Crohn’s disease — and more than 1.7 times as likely to develop ulcerative colitis.

There’s also evidence that the gut and immune system are interconnected.

A 2019 review of studies suggests that gut inflammation, potentially caused by a lack or imbalance of bacteria, could be a risk factor for both psoriasis and IBD (and potentially other digestive, immune, and skin issues).

Psoriasis and IBD each have their own set of specific symptoms. Learning about the symptoms of each condition can help you monitor whether you may be developing one of these conditions, especially if you’ve already been diagnosed with psoriasis or IBD.

Symptoms of psoriasis

Psoriasis symptoms vary depending on what type of psoriasis you have:

• Plaque psoriasis: The most common type of psoriasis. It causes thick, dry, itchy raised patches on the skin, often coated with a whitish coating called scale.
• Guttate psoriasis: Guttate psoriasis can cause tiny pinkish-red bumps to emerge suddenly on the skin of the torso, legs, and arms, as well as the face, scalp, and ears. These spots usually are temporary, fading within weeks or months without any treatment. But in some people, these spots may last for life or flare up repeatedly over time.
• Inverse psoriasis: This type can develop where skin touches skin in areas like the armpits, genitals, and crease between the buttocks. It tends to cause smooth, red patches of skin that are painful, sore, and raw with little or no scale.
• Pustular psoriasis: This type happens when pus-filled bumps appear on the hands and feet. You may also notice red skin, extremely sore skin, scale, and brown dots on the skin.
• Nail psoriasis: Nail psoriasis causes tiny dents in the nails and sometimes discoloration, crumbling, and roughness. The nail may detach or be lifted up.
• Psoriatic arthritis: This type affects the joints. Some early symptoms include having a swollen or tender joint (usually in a finger or toe), heel pain, swelling on the back of the leg above the heel, and feeling stiff in the morning.

Symptoms of IBD

IBD symptoms mostly affect the digestive tract. Specific symptoms can vary based on the condition that’s causing a person’s IBD.

People with a type of IBD called ulcerative colitis may experience the following symptoms on and off for periods of weeks or years during their lifetimes:

• abdominal cramping and pain
• blood in stool
• diarrhea
• fatigue
• fever
• nausea
• passing mucus or pus in the stool
• rectal bleeding
• tenesmus (feeling a constant urge to have a bowel movement)
• vomiting
• weight loss

A person experiencing Crohn’s disease may experience a wide range of symptoms, particularly during times of stress or when inflammation is triggered by eating certain foods. Symptoms can include:

• abdominal cramping and pain
• anemia
• eye redness or pain
• diarrhea
• fatigue
• fever
• joint pain or soreness
• loss of appetite
• nausea
• skin changes including tender bumps under the skin
• weight loss

No cure yet exists for either psoriasis or IBD. But there are things you can do to help minimize symptoms if you’re experiencing one or both of these conditions.

Medical treatment

Psoriasis and IBD are often treated with similar medications. A doctor may prescribe one of the following treatments:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter (OTC) medications like aspirin and ibuprofen (Advil) can all help reduce pain and swelling. Doctors can prescribe stronger versions of these medications if OTC versions aren’t enough to relieve your pain.
• Biologics: These are medications made from living organisms that help stop the immune system from producing proteins responsible for inflammation in the skin or bowels. A 2018 research review suggests that biologics, including infliximab and adalimumab, are “safe and effective” for treating psoriasis and IBD, including ulcerative colitis and Crohn’s disease.
• Steroids: Steroids like prednisone can be used during a Crohn’s flare-up. Corticosteroid creams or ointments can also be used to relieve pain and swelling associated with psoriasis flare-ups. Doctors may also prescribe glucocorticoids to help reduce damage caused by autoimmune inflammation.
• Methotrexate: This is an immune system suppressant called an immunomodulator that helps stop white blood cells from attacking your body’s healthy cells. This is typically used for severe cases of psoriasis and has been used in clinical trials for IBD.

Lifestyle tips

Researchers suggest that living a healthy lifestyle by reducing stress, exercising, and sleeping enough can all help reduce psoriasis and IBD symptoms.

But due to the close links between both issues and gut health, it’s worth paying some extra attention to your diet.

If you don’t already, consider the following dietary changes:

• Probiotics:Probiotics can help to repopulate your gut microbiome with healthy bacteria and restore its balance, especially if you’re taking NSAIDs over a long period of time.
• Mediterranean diet: A Mediterranean diet rich in plants, fibers, healthy oils, and lean proteins can help boost gut health . Be sure to talk with a doctor or nutritionist to make sure none of these types of foods will worsen your psoriasis or IBD symptoms, especially during a flare-up.

It’s not fully understood why psoriasis and IBD often occur together. But these issues often go hand in hand. Gut health may play a role in the development of psoriasis and IBD.

Making lifestyle and dietary changes and seeking medical treatment can help alleviate symptoms and get you closer to leading a life that’s as full and healthy as you want it to be.

Last medically reviewed on March 10, 2023