What proportion of EIMs in IBD are considered activity‑dependent versus independent of intestinal inflammation

The excerpts describe EIMs qualitatively rather than giving a numeric proportion split between activity-dependent and activity-independent. No percentage breakdown is provided ^1,2. What is stated is which specific manifestations fall into each group: episcleritis, erythema nodosum, oral aphthous ulcers, and pauciarticular (peripheral) arthritis are directly related to bowel disease activity and typically improve when the intestinal disease is treated, whereas ankylosing spondylitis and uveitis run independent of intestinal activity, and pyoderma gangrenosum and primary sclerosing cholangitis have an unclear/ambiguous relationship ^2–4. ^1–4

What is known: - One source states that most EIMs are directly associated with an ongoing intestinal flare, including aphthous ulcers, pauciarticular arthritis, erythema nodosum, and episcleritis. ¹ - EIMs are grouped into three categories: directly related to bowel activity (episcleritis, erythema nodosum, oral aphthous ulcers, pauciarthritis); not related (ankylosing spondylitis, uveitis); and unclear (pyoderma gangrenosum, primary sclerosing cholangitis). ² - Activity-associated EIMs usually improve with treatment of the intestinal activity, while uveitis and ankylosing spondylitis usually occur independent of intestinal activity. ^3,4 - Overall EIMs are reported in 5% to 50% of IBD patients. ¹

What is unknown / caveats: - No excerpt reports a numeric proportion or percentage split between activity-dependent and activity-independent EIMs - Pyoderma gangrenosum and primary sclerosing cholangitis are described as having an unclear relationship, so they fit neither category cleanly - The excerpts characterize categories qualitatively but do not quantify how many EIMs fall into each.

## References

1. Malik TF, Aurelio DM. Extraintestinal Manifestations of Inflammatory Bowel Disease. 2026. PMID: 33760556.

2. Kim JM, Cheon JH. Pathogenesis and clinical perspectives of extraintestinal manifestations in inflammatory bowel diseases. Intest Res. 2020. PMID: 32295331.

3. Vavricka SR, Schoepfer A, Scharl M, Lakatos PL, Navarini A, Rogler G. Extraintestinal Manifestations of Inflammatory Bowel Disease. Inflamm Bowel Dis. 2015. PMID: 26154136.

4. Alhalabi M, Ali Deeb S, Ali F, Abbas A. Ulcerative colitis-associated bronchiectasis: A rare extraintestinal manifestation of inflammatory bowel disease: A case report. Medicine (Baltimore). 2022. PMID: 36042661.

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_Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct._