Brief Article
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World J Gastroenterol. Oct 21, 2010; 16(39): 4952-4957
Published online Oct 21, 2010. doi: 10.3748/wjg.v16.i39.4952
Pulmonary involvement in inflammatory bowel disease
Aydın Yılmaz, Nilgün Yılmaz Demirci, Derya Hoşgün, Enver Üner, Yurdanur Erdoğan, Atila Gökçek, Atalay Çağlar
Aydın Yılmaz, Nilgün Yılmaz Demirci, Yurdanur Erdoğan, Atatürk Chest Disease and Chest Surgery Training and Research Hospital, Pulmonary Medicine, 06000 Ankara, Turkey
Derya Hoşgün, Department of Pulmonary Medicine, Agrı Public Hospital, 04000 Agrı, Turkey
Enver Üner, Numune Education and Research Hospital, Gastroenterology, 06000 Ankara, Turkey
Atila Gökçek, Atatürk Chest Disease and Chest Surgery Training and Research Hospital, Radiology, 06000 Ankara, Turkey
Atalay Çağlar, Pamukkale University Faculty of Economic and Administrative Sciences, 20000 Denizli, Turkey
Author contributions: Yılmaz A and Yılmaz Demirci N arranged the study and wrote the manuscript; Hoşgün D collected the data; Üner E performed endoscopy; Erdoğan Y checked and helped with writing the discussion; Gökçek A evaluated HRCTs; Çağlar A performed the statistical analysis.
Correspondence to: Nilgün Yılmaz Demirci, MD, Atatürk Chest Disease and Chest Surgery Training and Research Hospital, Pulmonary Medicine, 06000 Ankara, Turkey.
Telephone: +90-312-3552110 Fax: +90-312-3552135
Received: June 16, 2010
Revised: July 8, 2010
Accepted: July 15, 2010
Published online: October 21, 2010

AIM: To determine the relationship of pulmonary abnormalities and bowel disease activity in inflammatory bowel disease (IBD).

METHODS: Thirty ulcerative colitis (UC) and nine Crohn’s disease patients, and 20 control subjects were enrolled in this prospective study. Detailed clinical information was obtained. Extent and activity of the bowel disease were established endoscopically. Each patient underwent pulmonary function tests and high-resolution computed tomography (HRCT). Blood samples for measurement of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), angiotensin converting enzyme and total IgE were delivered by the patients.

RESULTS: Ten (25.6%) patients had respiratory symptoms. A pulmonary function abnormality was present in 22 of 39 patients. Among all patients, the most prevalent abnormalities in lung functions were a decrease in forced expiratory volume in 1 s (FEV1), FEV1/forced vital capacity (FVC), forced expiratory flow (FEF) 25%-75%, transfer coefficient for carbon monoxide (DLCO), DLCO/alveolar volume. Increased respiratory symptoms score was associated with high endoscopic activity index in UC patients. Endoscopic and clinical activities in UC patients were correlated with FEV1, FEV1/FVC, and FEF 25%-75%. Smoking status, duration of disease and medication were not correlated with pulmonary physiological test results, HRCT abnormalities, clinical/endoscopic disease activity, CRP, ESR or total IgE level or body mass index.

CONCLUSION: It is important that respiratory manifestations are recognized and treated early in IBD. Otherwise, they can lead to destructive and irreversible changes in the airway wall.

Keywords: Inflammatory bowel disease, Ulcerative colitis, Crohn’s disease, High-resolution computed tomography, Pulmonary function tests, Lung diseases