Inflammatory bowel disease and asthma. Results from the RHINE study

Respir Med.?2023 Sep;216:107307.?doi: 10.1016/j.rmed.2023.107307.?Epub 2023 Jun 2. 


Marta A Kisiel?1,?Martin Sedvall?2,?Andrei Malinovschi?3,?Karl A Franklin?4,?Thorarinn Gislason?5,?Vivi Shlunssen?6,?Ane Johansson?7,?Lars Modig?8,?Rain Jogi?9,?Mathias Holm?10,?Cecilia Svanes?11,?Louise Lindholdt?6,?Marie Carlson?12,?Christer Janson?2 


Author information

1Department of Medical Sciences: Environmental and Occupational Medicine, Uppsala University, Uppsala, Sweden. Electronic address: marta.kisiel@medsci.uu.se. 

2Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden. 

3Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden. 

4Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden. 

5The Medical Faculty, University of Iceland, Reykjavik, Iceland; Department of Sleep, Landspitali University Hospital Reykjavik, Reykjavik, Iceland. 

6Dept of Public Health, Danish Ramazzini Centre, Aarhus University and the National Research Centre for the Working Environment, Copenhagen, Denmark. 

7Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. 

8Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden. 

9The Lung Clinic, Tartu University Hospital, Tartu, Estonia. 

10Section of Occupational and Environmental Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. 

11Dept of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway. 

12Department of Medical Sciences, Gastroenterology Research Group, Uppsala University, Uppsala, Sweden. 


Background:?Asthma and inflammatory bowel disease (IBD) are common inflammatory diseases. The aim of this study was to investigate the associations of IBD with asthma and respiratory symptoms. 

Methods:?This study is based on 13,499 participants from seven northern European countries that filled in a postal questionnaire on asthma, respiratory symptoms, IBD including ulcerative colitis and Crohn's disease and various lifestyle variables. 

Results:?There were 195 participants with IBD. The prevalence of asthma (14.5 vs 8.1%, p = 0.001), different respiratory symptoms (range 11.9-36.8% vs range 6.0-18.6%, p < 0.005), non-infectious rhinitis (52.1 vs. 41.6%, p = 0.004) and chronic rhinosinusitis (11.6 vs 6.0%, p = 0.001) were higher in subjects with IBD than in those without IBD. In multivariable regression analysis, the association between IBD and asthma was statistically significant (OR 1.95 (95% CI 1.28-2.96)) after adjusting for confounders such as sex, BMI, smoking history, educational level and physical activity. There was a significant association between asthma and ulcerative colitis (adjusted OR 2.02 (95% CI 1.27-2.19)), and asthma but not Crohn's disease (adjusted OR 1.66 (95% CI 0.69-3.95)). A significant gender interaction was found with a significant association between IBD and asthma in women but not in men ((OR 2.72 (95% CI 1.67-4.46) vs OR 0.87 (95% CI 0.35-2.19), p = 0.038). 

Conclusions:?Patients with IBD, particularly those with ulcerative colitis and female, have a higher prevalence of asthma and respiratory symptoms. Our findings indicate that it is important to consider respiratory symptoms and disorders when examining patients with manifest or suspected IBD. 

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