IBD, which includes ulcerative colitis and Crohn’s disease, involves the chronic inflammation of part or all of the digestive tract. Symptoms range from cramping and fatigue to abdominal pain, diarrhea, ulcers, and malnutrition. In this Danish study of more than 5 million adults, presented at the Heart Failure Congress 2014, researchers analyzed data and followed up with more than 23,000 IBD patients. They found that overall, patients with IBD have a 37% increased risk of heart failure hospitalization compared to the healthy population. But when there’s a flare-up—or an active period of symptoms—the risk increases 2.5 times. Experts don’t quite understand what causes IBD flare-ups, which vary greatly in frequency and severity among patients, and they’re also unsure why heart risk goes up in step with them. In general, the connection between IBD and cardiovascular health is understood to be inflammation, says lead author Soeren Lund Kristensen, a research fellow at Gentofte University Hospital in Copenhagen. “We know inflammation may lead to an increased risk of thrombosis (a clot in a blood vessel), and some studies show inflammation in the circulation may also lead to vascular damage.” IBD also puts you at risk for anemia, which may contribute to the development of heart failure, he says.  People with mild IBD likely don’t need to worry, Kristensen explains. “But if someone is experiencing frequent flare-ups, and especially if they’re taking steroids for them, they should be vigilant and discuss their heart health with their physician.” More from Prevention: Is It Heartburn…Or Something More Serious?