A higher incidence of inflammatory bowel disease (IBD) has been found in persons with airway diseases, such as asthma and chronic obstructive pulmonary disease (COPD), in a study published online ahead of print in European Respiratory Journal.
Lead author Paul Brassard, MD, and fellow investigators determined that the incidence of Crohn disease was 27% higher in persons with asthma and 55% higher in persons with COPD, and that incidence of ulcerative colitis was 30% higher in persons with COPD.
These percentages were determined in comparison with the general population of Québec, which the investigators noted is the province with the second-highest incidence of Crohn disease in Canada and a prevalence of asthma and COPD that is above the Canadian average.
“Although a link has previously been suggested, this is the first study to find significantly increased rates of IBD incidence in people with asthma and COPD,” said Brassard in a statement from the European Lung Foundation. “If we can confirm a link between the two conditions it will help diagnose and treat people sooner, reducing their symptoms and improving their quality of life.”
The researchers noted in their study that when patients with airway disease develop digestive symptoms, clinicians need to be aware of the possible occurrence of new cases of IBD, even in older age groups and regardless of smoking status.
Brassard’s group identified 136,178 persons with asthma and 143,904 persons with COPD in the administrative health databases of Québec. Among those with asthma, there was an average incidence of 23.1 cases of Crohn disease and 8.8 cases of ulcerative colitis per 100,000 person-years.
Among persons with COPD, there were 26.2 cases of Crohn disease and 17 cases of ulcerative colitis per 100,000 person-years. The incidence of both Crohn disease and ulcerative colitis in elderly patients with COPD was significantly higher than in the general population.
Women with asthma were more likely than men to develop Crohn disease, and men with COPD were more likely than women to develop ulcerative colitis.
The researchers pointed out that immunologic dysfunctions triggered by environmental factors are a common element in the pathogenesis of both IBD and airway diseases such as asthma and COPD, and that pulmonary involvement is one of the extraintestinal manifestations of IBD.