Patients with Crohn' s disease can develop multiple metabolic abnormalities. They have increased absorption of ox-alate that leads to kidney stones and a disrupted enterohepatic circulation with increased frequency of gallstones. Metabolic bone disease is a complication of IBD, either because of vita-min D malabsorption or as a side effect of steroid use. Other rare complications include acute pancreatitis, pleuroperi-carditis, fibrosing alveolitis, bronchiolitis obliterans, club-bing, hypertrophic osteoarthropathy, and amyloidosis.

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