[PHNUTR-L] People with IBD more likely to suffer from debilitating
respiratory and nerve disorders
Kathrynne Holden, MS, RD
fivestar at nutritionucanlivewith.com
Fri Sep 2 06:14:38 PDT 2005
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
Contact: Kimberly Wise
media at gastro.org
American Gastroenterological Association
People with IBD more likely to suffer from debilitating respiratory and
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
"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
Researchers: Patients with IBD More Likely to Be Diagnosed with Multiple
(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
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
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
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 >
"Ask the Parkinson Dietitian" http://www.parkinson.org/
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