People with inflammatory bowel disease are usually treated for problems in the digestive system, but the condition can sometimes affect other parts of the body.
New research suggests that a serious type of lung disease may be more common in people with ulcerative colitis than in those with Crohn’s disease.
Inflammatory bowel disease, or IBD, is a name for long-lasting conditions that cause inflammation in the digestive tract. The two main forms are ulcerative colitis and Crohn’s disease. Ulcerative colitis mainly affects the large intestine, while Crohn’s disease can affect different parts of the digestive system.
Researchers from the University of Florida College of Medicine in Jacksonville examined a lung problem known as interstitial lung disease, or ILD. This is a group of conditions that cause inflammation or scarring in the tissue around the tiny air sacs in the lungs. As the damage gets worse, it can become harder for oxygen to move into the blood.
Symptoms can include shortness of breath, a dry cough and tiredness, although some people may have few symptoms early on. Lung scarring can sometimes become permanent, which makes early recognition important. The researchers wanted to understand how often ILD occurs in people with IBD and which patients may face greater risks.
The team studied medical information from 8,865 people with inflammatory bowel disease. The patients had received care at two large medical centers in the southeastern United States between 2012 and 2022. The researchers compared people who had Crohn’s disease with those who had ulcerative colitis.
Overall, 4.6% of the patients had both inflammatory bowel disease and interstitial lung disease. However, ILD was significantly more common among people with ulcerative colitis than among those with Crohn’s disease. The general demographic characteristics of the two groups with lung disease were otherwise similar.
The study also found differences between people who had IBD alone and those who had both IBD and ILD. Patients with both conditions tended to be older. They were also more likely to visit emergency departments and be admitted to hospital.
People with both bowel and lung disease were also more likely to have used steroid medicines. Steroids can reduce inflammation and are often used when inflammatory bowel disease becomes more active. However, long-term steroid use can cause important side effects, so doctors usually try to limit it when possible.
The researchers also found that patients with both conditions were less likely to have been prescribed mesalamine. This medicine is commonly used to control inflammation in ulcerative colitis. The study did not show that the medicine itself caused or prevented lung disease.
Another finding involved other health problems. These were more common among minority patients with both IBD and ILD than among White patients in the study. The researchers said more work is needed to understand the reasons for these differences.
It is important to remember that lung problems in people with IBD can have several possible causes. Inflammation connected with IBD may affect organs outside the digestive tract, while infections, smoking, other illnesses and some medicines can also affect the lungs. Doctors therefore need to look carefully at each patient’s situation.
The authors said the combination of IBD and ILD creates a greater burden on patients and the health care system. Because lung disease can be difficult to recognize early, they suggested that doctors consider earlier detection and screening in people with inflammatory bowel disease.
Where medical resources are limited, people with ulcerative colitis may deserve particular attention because they showed the higher rate in this study.
The research was led by Sneh Parekh, D.O., from the University of Florida College of Medicine in Jacksonville. It was published online July 24 in the journal Crohn’s & Colitis 360. The findings highlight an important reminder that inflammatory bowel disease can sometimes have effects far beyond the gut.
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