A new study suggests that some people with long-term bowel conditions may also be at risk of a lung problem involving scarring and inflammation. The link appeared stronger in people with ulcerative colitis than in those with Crohn’s disease. Researchers say the findings may help doctors pay closer attention to breathing symptoms in people living with these conditions.
Background
Inflammatory bowel disease (IBD) is a term covering two main conditions, ulcerative colitis and Crohn’s disease. Both involve the immune system causing ongoing inflammation in the digestive system. Ulcerative colitis affects the large intestine, while Crohn’s disease can affect any part of the digestive tract. People with IBD often experience stomach pain, diarrhoea, tiredness and weight loss, and the condition can sometimes affect other parts of the body, including the joints, skin and eyes.
The study looked at whether IBD might also be linked to interstitial lung disease (ILD), a group of lung conditions that cause inflammation and, in some cases, scarring around the tiny air sacs used for breathing. Early ILD may cause no obvious symptoms, but if scarring becomes severe, it may not be reversible. Symptoms can include a persistent dry cough, breathlessness and tiredness.
What the researchers found
The research team, led by Sneh Parekh from the University of Florida College of Medicine, reviewed medical records from 8,865 people with IBD treated at two specialist centres in the southeastern United States between 2012 and 2022.
According to the study authors, around 4.6 per cent of these patients had both IBD and ILD. Lung disease was reported more often among people with ulcerative colitis than among those with Crohn’s disease.
People who had both conditions tended to be older and were more likely to need emergency care or hospital admission, suggesting that having both illnesses together may place a greater strain on health. The researchers also noted that patients with both conditions were more likely to have been given steroid medicines, which are used to control inflammation, and less likely to have been prescribed mesalamine, a medicine commonly used for ulcerative colitis. Other health conditions were also reported more often among patients from minority backgrounds who had both IBD and ILD, although the study did not explain why.
Why this matters
The exact reason bowel and lung problems might occur together is not fully understood. IBD involves immune activity that is not limited to the gut, so researchers suggest inflammation may sometimes reach other organs, including the lungs. Medicines, infections and unrelated lung conditions could also play a part. The study authors said doctors should consider the possibility of lung involvement in people with IBD, particularly when breathing symptoms cannot be easily explained, and suggested that closer monitoring may be worth considering, especially for people with ulcerative colitis.
What to keep in mind
- This was an observational study, meaning it can show two conditions appearing together but cannot prove that one directly causes the other.
- The patients were treated at specialist centres, so the results may not reflect the wider population of people with IBD.
- The 4.6 per cent figure does not mean most people with IBD will develop serious lung problems.
- Further research involving different hospitals and patient groups is needed to understand how common this link truly is.
- People with IBD are encouraged to mention a persistent cough or unexplained breathlessness to their doctor rather than assuming it is unrelated to their bowel condition.
Reference
Parekh S, et al. University of Florida. Findings published online 24 July in Crohn’s & Colitis 360.
This article is a journalistic summary for informational purposes only. It does not constitute clinical advice or a recommendation to alter treatment decisions.