Published online Nov 14, 2019. doi: 10.3748/wjg.v25.i42.6354
Peer-review started: July 2, 2019
First decision: August 2, 2019
Revised: September 18, 2019
Accepted: October 17, 2019
Article in press: October 17, 2019
Published online: November 14, 2019
Inflammatory bowel disease (IBD) is known to be associated with airway disease and there is a growing evidence of increased risk of IBD among patients with chronic obstructive pulmonary disease (COPD).
South Korea has a considerably high prevalence of COPD and is one of the highest incidence of IBD among Asian countries. Previous western studies have reported the risk of IBD in COPD patients, however, no research based on Asian data has been reported.
To estimate the incidence of IBD in patients with COPD compared to non-COPD controls and the risk of IBD development according to COPD severity.
From January 2010 and December 2014, patients with COPD were identified using International Classification of Disease, 10th revision (ICD-10 code) and prescription records from the National Health Insurance (NHI) database. The COPD patients were divided into the severe and the mild COPD group. And these patients were subsequently 1:5 matches with individuals without COPD. Newly diagnosed IBD patients with Crohn’s disease and ulcerative colitis were identified using ICD-10 code and the rare intractable disease registration program codes from NHI database. The risk of IBD in COPD patients compared to controls was analyzed by Cox proportional hazard regression models. The cumulative incidence of IBD were compared between the groups.
The COPD group had higher incidences of IBD compared to non-COPD controls and the risk of IBD in the COPD group was increased. The incidence rate of IBD was higher in the severe COPD group than in the mild COPD group.
The incidences of IBD were significantly increased in COPD patients in South Korea and the risk of developing IBD also increased as the severity of COPD increased.
Careful monitoring the gastrointestinal symptoms indicative of IBD in COPD patients is important. Accurate clinical assessment should be done, especially in patients with severe COPD in order to determine the best strategies to prevent complications.