[PHNUTR-L] People with IBD more likely to suffer from debilitating respiratory and nerve disorders

[Kathrynne Holden, MS, RD]

Colleagues, the following is FYI and does not necessarily reflect my own
opinion. I have no further knowledge of the topic.
------------------------
Public release date: 1-Sep-2005
http://www.eurekalert.org/pub_releases/2005-09/aga-pwi083005.php

Contact: Kimberly Wise
media at gastro.org
301-941-2620
American Gastroenterological Association

People with IBD more likely to suffer from debilitating respiratory and 
nerve disorders

Bethesda, Maryland (Sept. 1, 2005) – According to two studies published 
today in the American Gastroenterological Association (AGA) journal 
Gastroenterology, people with inflammatory bowel disease are more prone 
to developing severe disorders of the respiratory and nervous systems. 
The studies found an increase in the prevalence of asthma, arthritis, 
chronic renal disease, multiple sclerosis and psoriasis, among other 
disorders.

"These studies remind us that the effects of inflammatory bowel 
disorders extend to every corner of the body, including the lungs and 
central nervous system," said Edward V. Loftus, Jr., MD, author of an 
editorial appearing in this month's journal and associate professor of 
medicine at the Mayo Clinic College of Medicine. "The findings lend 
credence to the concept that patients with one chronic inflammatory 
condition are more likely than the general population to develop another."

Inflammatory bowel disease (IBD) is a term that refers to both 
ulcerative colitis and Crohn's disease. According to the most recent 
data from the National Health Interview Survey, there are more than two 
million prevalent cases of Crohn's disease and more than one million 
cases of ulcerative colitis in the U.S.

Ulcerative colitis, a condition in which the lining of the large 
intestine becomes inflamed and ulcerated, most commonly affects people 
between 15 and 40 years of age. Common symptoms include abdominal 
cramps, bloody diarrhea, fever, weight loss and rectal bleeding. People 
with chronic, severe ulcerative colitis are at an increased risk of 
developing colorectal cancer. Crohn's disease causes chronic 
inflammation of the intestinal wall. While the cause of Crohn's is 
relatively unknown, it usually starts during the teenage years or early 
adulthood and is characterized by pain in the abdomen, diarrhea and 
weight loss.

Researchers: Patients with IBD More Likely to Be Diagnosed with Multiple 
Sclerosis
(Increased Risk of Demyelinating Diseases in Patients with Inflammatory 
Bowel Disease, Gupta, et al.)
A possible association between inflammatory bowel disease and multiple 
sclerosis (MS) has been suspected for decades, but previous studies have 
lacked the statistical power to confirm the relationship. A study 
published in this month's Gastroenterology is the first to confirm a 
nearly two-fold increased risk of multiple sclerosis in IBD patients. In 
addition to MS, researchers from the University of Pennsylvania found an 
association between IBD, optic neuritis and other demyelinating disorders.

Patients being treated with anti-TNF alpha therapies, such as Remicade 
and Humira, were previously thought to be the only ones with an 
increased risk of developing these neurological disorders. As a result, 
clinician and patient label warnings were added to this class of drugs 
in 2004. Study authors say the causal relationship between these drugs 
and demyelinating disorders has not clearly been established because of 
the small amount of data available from controlled clinical trials.

"While our study findings do not refute an association between anti-TNF 
alpha medications and these disorders, they point out that IBD patients 
appear to have an increased risk of multiple sclerosis even when they 
are not being treated with these medications," said James D. Lewis, MD, 
MSCE, study author from the University of Pennsylvania. "The development 
of neurologic symptoms in patients with IBD should prompt their 
physician to look for evidence of multiple sclerosis and other nervous 
system disorders."

This study identified more than 20,000 patients from the UK's General 
Practice Research Database diagnosed with Crohn's disease and ulcerative 
colitis between January 1988 and October 1997. Each study subject was 
then matched to four controls, making for an inclusion of about 80,000 
control subjects without IBD. The odds of an IBD patient being diagnosed 
with multiple sclerosis, optic neuritis and other demyelinating 
disorders was found to be 1.7 times as high as those patients without 
IBD. If the association is confirmed by other studies, researchers 
believe findings may help to identify common genetic or environmental 
factors contributing to the development of Crohn's and ulcerative colitis.

People with Crohn's and Colitis at Greater Risk of Asthma, Researchers Say
(The Clustering of Other Chronic Inflammatory Diseases in IBD: A 
Population-Based Study, Bernstein, et al.)
In a similar study also published in this month's Gastroenterology, 
Canadian researchers looked at the relationship between IBD and common 
respiratory and neurological diseases. Results of this study suggest 
that the people with IBD have a significantly increased prevalence of 
asthma, bronchitis, arthritis and psoriasis. While some of these 
co-morbidities have been found previously, this study is the first to 
discover a significantly higher prevalence of asthma in IBD patients 
compared with non-IBD patients.

"People with IBD are 1.5 times as likely to have asthma as people in the 
general population," said Charles N. Bernstein, MD, lead study author 
from the University of Manitoba in Canada. "Airway diseases are the 
second most common chronic inflammatory disease assessed in patients 
with either Crohn's disease or ulcerative colitis."

Study data comes from the University of Manitoba IBD database, which 
included 8,072 people diagnosed with IBD over a 19-year period. Each of 
these people was matched randomly with 10 members of the general 
population by age, gender and geographic location. Ulcerative colitis 
patients were 50 to 70 percent more likely than the general population 
to have asthma, while Crohn's patients were about 30 to 40 percent more 
likely.

Overall, people with IBD had a significantly higher prevalence than the 
general population for the following disorders: asthma, bronchitis, 
arthritis, multiple sclerosis, chronic renal disease, psoriasis and 
pericarditis. This study is the largest population-based study to assess 
the co-morbidity of these important immune-based diseases. Differences 
were not only found between the two diseases, but also in gender and 
age. Females had a greater percentage of pulmonary co-morbidities than 
males and more old people had bronchitis.

"The findings from this study highlight an often overlooked association 
between intestinal disorders and the respiratory system," said Loftus. 
"Long-term consequences of untreated pulmonary involvement in IBD are 
substantial and physicians should at least follow-up respiratory 
complaints with pulmonary function tests."

More information on inflammatory bowel disease is available at 
www.gastro.org.

About the Studies

Increased Risk of Demyelinating Diseases in Patients with Inflammatory 
Bowel Disease, Gupta, et al.
Researchers from the University of Pennsylvania conducted a 
retrospective cross-sectional study and a cohort study to examine the 
association of IBD and multiple sclerosis, demyelination and optic 
neuritis to determine if these conditions are more common in IBD 
patients than non-IBD patients. The General Practice Research Database 
was used to gather the study population, which consisted of 20,173 
patients from the United Kingdom with ulcerative colitis or Crohn's 
disease diagnoses between January 1988 and October 1997. Support for 
this research was provided by the National Institutes of Health.

The Clustering of Other Chronic Inflammatory Diseases in IBD: A 
Population-Based Study, Bernstein, et al.
Researchers at the University of Manitoba Inflammatory Bowel Disease 
Clinical and Research Centre in Canada conducted a population-based 
study to assess the number of additional chronic inflammatory conditions 
in patients with inflammatory bowel disease. The study population was 
derived from the University of Manitoba IBD database, which includes all 
people in the Manitoba health care system with a Crohn's disease and 
ulcerative colitis diagnosis. The study population consisted of 8,072 
people with IBD diagnoses between April 1, 1984 and March 31, 2003. This 
research was partially supported by the Crohn's and Colitis Foundation 
of Canada and the Canadian Institutes of Health Research.
-- 
Kathrynne Holden, MS, RD < fivestar at nutritionucanlivewith.com >
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