If you have inflammatory bowel disease (IBD) — ulcerative colitis (UC) or Crohn’s disease in particular — you may have heard of a link to the herpes virus.
To understand the link, it’s important to note that treatment for IBD often involves immunosuppressants. Suppressing the immune system can increase your risk of developing opportunistic infections.
One of these infections is the herpes simplex virus (HSV), and a complication of that virus for people with IBD is herpes simplex virus colitis.
The herpes virus can cause further inflammation of the large intestine, exacerbating the existing bowel disease.
Herpes simplex virus colitis can’t develop unless a person with IBD contracts HSV.
There are two main types of the virus:
- HSV-1, which is transmitted by close nonsexual and sexual contact and mainly causes oral herpes
- HSV-2, which is usually transmitted via sexual contact and mainly causes genital herpes
If a person contracts HSV, the virus remains inside the body for life. It’s often dormant for long periods of time but can reactivate at certain points.
Immunosuppressive treatment for IBD can lead to some people becoming immunocompromised.
This status may then contribute to the reactivation of the virus, potentially resulting in more severe symptoms and complications like herpes simplex virus colitis.
HSV is a common infection across the globe. An estimated 67% of people have contracted HSV-1, and around 13% of people have contracted HSV-2.
But colitis caused by the virus is a rare complication in people with IBD.
It was
People with IBD who are immunocompromised are thought to be at a
That’s because some of the treatment for IBD, such as corticosteroids, suppresses the immune system to help prevent and reduce the inflammation caused by the disease.
But the same dampened immune system response can put the body more at risk of certain infections, severe progressions, and complications associated with those infections.
It also increases the risk of reactivating a dormant herpes infection that already exists inside a person’s body.
Finally, persistent inflammation in the body may also boost the risk of HSV infection and thereby the risk of colitis caused by the virus later on.
Many people with HSV don’t have noticeable symptoms.
When symptoms do occur, they typically include oral or genital sores, which can be more severe in an immunocompromised person.
Flu-like symptoms are also possible. This includes:
- fever
- sore throat
- headache
- fatigue
- muscle and joint pain
Colitis caused by this virus has symptoms that are more typical of general colitis. This includes:
- stomach pain, cramps, and bloating
- fever
- diarrhea that may have blood present
- nausea
- lack of appetite
- weight loss
Although antibody tests can show whether a person has previously contracted HSV, they’re not usually used to detect an active infection.
Instead, a doctor or other healthcare professional will usually take a sample of blood or stool and test for the presence of the virus using a polymerase chain reaction test.
A clinician may also perform a physical examination or request imaging tests to check for specific signs of colitis.
Antiviral medication is usually prescribed for a few weeks.
The medication targets the virus and stops it from being able to replicate inside the body.
Sometimes, if a case is severe, immunosuppressant treatment for IBD is stopped until the symptoms of herpes simplex virus colitis improve.
Although the condition itself is rare, herpes simplex virus colitis can be fatal.
In people who are receiving treatment for IBD, the virus can cause serious conditions such as hepatitis, encephalitis, or pneumonitis, as well as colitis.
There’s also an increased risk of a colectomy, where all or part of the colon needs to be surgically removed.
If you’re experiencing symptoms like diarrhea, bloody stool, and stomach pain, seek medical attention as soon as possible.
This is even more vital if you’ve received an IBD diagnosis and find that your symptoms are worsening.
The quicker herpes simplex virus colitis can be diagnosed and treated, the less chance of complications.
Herpes simplex virus colitis is rare in the medical literature, only showing up a handful of times in people being treated for IBD, including those with ulcerative colitis and Crohn’s disease.
It’s thought to be a result of IBD treatment’s ability to suppress the immune system, leading to reactivation of the HSV.
But it can lead to serious complications without prompt treatment.
So if you have IBD and are concerned about your symptoms or think you might have IBD but haven’t received a diagnosis, consult with a doctor or other healthcare professional.
Lauren Sharkey is a U.K.-based journalist and author specializing in women’s issues. When she isn’t trying to discover a way to banish migraines, she can be found uncovering the answers to your lurking health questions. She has also written a book profiling young female activists across the globe and is currently building a community of such resisters. Catch her on Twitter.