Pulmonary manifestations of inflammatory bowel disease

Abstract

Extraintestinal manifestations of inflammatory bowel disease (IBD) are a systemic illness that may affect up to half of all patients. Among the extraintestinal manifestations of IBD, those involving the lungs are relatively rare and often overlooked. However, there is a wide array of such manifestations, spanning from airway disease to lung parenchymal disease, thromboembolic disease, pleural disease, enteric-pulmonary fistulas, pulmonary function test abnormalities, and adverse drug reactions. The spectrum of IBD manifestations in the chest is broad, and the manifestations may mimic other diseases. Although infrequent, physicians dealing with IBD must be aware of these conditions, which are sometimes life-threatening, to avoid further health impairment of the patients and to alleviate their symptoms by prompt recognition and treatment. Knowledge of these manifestations in conjunction with pertinent clinical data is essential for establishing the correct diagnosis and treatment. The treatment of IBD-related respiratory disorders depends on the specific pattern of involvement, and in most patients, steroids are required in the initial management. Corticosteroids, both systemic and aerosolized, are the mainstay therapeutic approach, while antibiotics must also be administered in the case of infectious and suppurative processes, whose sequelae sometimes require surgical intervention.

Keywords: Inflammatory bowel diseases, Crohn’s disease, Ulcerative colitis, Lung diseases

Core tip: The clinicopathological patterns of pulmonary involvement in inflammatory bowel disease (IBD) consist of airway disease, lung parenchymal disease, thromboembolic disease, pleural diseases, enteric-pulmonary fistulas, and pulmonary function test abnormalities. The treatment of IBD-related respiratory disorders depends on the specific pattern of involvement, and in most patients, steroids are required in the initial management. This review focuses on the pulmonary manifestations of IBD in an attempt to avoid further health impairment and to alleviate symptoms by prompt recognition and treatment.