Colby Stong
Patients with inflammatory bowel disease (IBD) have a significantly increased prevalence of respiratory symptoms, asthma, and chronic rhinosinusitis (CRS) than those without IBD, according to a study in Respiratory Medicine.
Although IBD and asthma are both inflammatory diseases, it is unknown whether there is a link between the 2 diseases. Researchers therefore explored how IBD may be associated with asthma and respiratory symptoms, using data from the Respiratory Health in Northern Europe (RHINE) study, a large, cross-sectional, population-based study that followed participants from 7 Northern European cities: Bergen in Norway, Tartu in Estonia, and Uppsala, Umeå, and Gothenburg in Sweden, Reykjavik in Iceland, and Aarhus in Denmark. Postal questionnaires used in all RHINE stages asked about the presence of respiratory symptoms within the previous 12 months and were designed as yes/no questions. The current study is based on a RHINE follow-up questionnaire from 2010 to 2012.
The current analysis included 195 participants in the IBD group (155 with ulcerative colitis and 51 with Crohn’s disease; 6 had both conditions) and 11,960 in the no-IBD group. The IBD group had a mean [SD] age of 52.2 [7.0] years (55.9% female), and the no-IBD group had a mean age of 51.6 [7.2] years (53% female).
The analysis found that patients with IBD had a higher prevalence of wheeze, wheeze with breathlessness, nocturnal symptoms of chest tightness, nocturnal breathlessness, nocturnal cough, asthma, noninfectious rhinitis, and CRS compared with individuals without IBD. A significantly higher prevalence of most respiratory symptoms, asthma, and CRS was observed in patients with ulcerative colitis compared with those without ulcerative colitis. No significant difference was observed among individuals with and without Crohn’s disease regarding respiratory symptoms and respiratory disorders.
After adjustment for age, sex, body mass index, smoking history, educational level, exercise, and center, the association between IBD and several respiratory symptoms, asthma, noninfectious rhinitis, and CRS remained significant, as well as between ulcerative colitis and respiratory symptoms, asthma, and CRS. Odds ratios (ORs) in the IBD group were: asthma (1.95; 95% CI, 1.28-2.96); nocturnal breathlessness (2.20; 95% CI, 1.36-3.56); CRS (2.00; 95% CI, 1.25-3.20); and wheeze with breathlessness (1.64; 95% CI, 1.09-2.46).
Notably, a significant association occurred between IBD and asthma in women but not in men (OR 2.72; 95% CI, 1.67-4.46 vs OR 0.87; 95% CI, 0.35- 2.19; P =.038).
No significant associations were found between Crohn’s disease and respiratory symptoms and disorders.
Limitations include the use of self-reported data; a lack of data on the severity and specific disease characteristics of IBD; the inability to determine whether duration and severity of IBD was related concurrent asthma or asthma-related symptoms; and lack of data on medication and systemic use of corticosteroids. In addition, the incidence of Crohn’s disease was 3 times lower than ulcerative colitis.
“Patients with IBD, particularly those with ulcerative colitis and female, have a higher prevalence of asthma and respiratory symptoms,” concluded the researchers. “Our findings indicate that it is important to consider respiratory symptoms and disorders when examining patients with manifest or suspected IBD,” they added.
References:
Kisiel MA, Sedvall M, Malinovschi A, et al. Inflammatory bowel disease and asthma. Results from the RHINE study. Respir Med. Published online June 2, 2023. doi:10.1016/j.rmed.2023.107307