Researchers recently determined that patients with inflammatory bowel diseases (IBDs) are likely to have pulmonary function problems that often go undiagnosed.
The study, “Alterations of pulmonary function in patients with inflammatory bowel diseases,” was published in the journal Annals of Thoracic Medicine.
In IBDs, including Crohn’s disease (CD) and ulcerative colitis (UC), patients often develop extra-intestinal manifestations. Although rare, changes in the lungs may also occur. The prevalence of pulmonary involvement in IBD patients is largely unknown.
In the present study, a team of researchers from China’s Shandong University, The Third Chinese Traditional Hospital of Jinan, and Shandong Provincial Qianfoshan Hospital investigated alterations of pulmonary function tests (PFTs) and how they might be linked with IBD disease activity.
The study enrolled 64 IBD patients (31 with CD and 33 with UC) and a control group of 30 healthy people. They measured several parameters of PFTs, including forced expiratory volume (FEV1), forced vital capacity (FVC), mid-forced expiratory flow of 25–75% (FEF 25–75), residual volume, total lung capacity, and diffusing capacity of the lung for carbon monoxide (DLCO).
Disease activity was assessed by the Crohn’s Disease Activity Index for CD and the Mayo Clinic Score for UC. Researchers analyzed the results then correlated disease activity with PFT results and sputum cytology. Sputum cytology determines if abnormal cells are present in mucus coughed out of the lungs.
Sputum samples from 19 patients with CD and 17 patients with UC correlated with at least one abnormal PFT. When comparing CD and UC patients to healthy controls, both IBD groups showed significantly lower FEV1, FEF 25–75, and DLCO.
Active disease correlated with less lung function in the majority of IBD patients. In the sputum tests, no significant differences were found between CD and UC patients, but lymphocytosis (high level of white blood cells in the immune system), and eosinophilia (high counts of white blood cells that combat multicellular parasites and certain infections) were observed in active disease patients.
The study authors concluded that pulmonary function disorders could be common in IBD patients, and worse for those with active disease. Because PFTs in IBD patients can be detected even in remission, the authors suggested that PFTs may represent a noninvasive strategy to identify the level of activity in IBD disease and to detect early stages of pulmonary problems.