Gastroenterology

Gastroenterology

Volume 129, Issue 3, September 2005, Pages 827-836
Gastroenterology

Clinical–alimentary tract
The Clustering of Other Chronic Inflammatory Diseases in Inflammatory Bowel Disease: A Population-Based Study

https://doi.org/10.1053/j.gastro.2005.06.021Get rights and content

Background & Aims: We aimed to discern the relative risk for several chronic inflammatory conditions in patients with ulcerative colitis (UC) and Crohn’s disease. Methods: We used the population-based University of Manitoba IBD Database that includes longitudinal files on all patients from all health system contacts identified by International Classification of Diseases, 9th revision, Clinical Modification codes for visit diagnosis. From the provincial database we extracted a control cohort matching the IBD patients 10:1 by age, sex, and geography. We considered a potential comorbid disease to be present if the patient had 5 or more health system contacts for that diagnosis. The comorbid disease period prevalence was analyzed separately for patients with UC and Crohn’s disease and a prevalence ratio was calculated comparing the IBD populations with the matched cohort. Results: There were 8072 cases of IBD from 1984 to 2003, including UC (n = 3879) and Crohn’s disease (n = 4193). There was a mean of approximately 16 person-years of coverage for both patients and control patients. Both UC and Crohn’s disease patients had a significantly greater likelihood of having arthritis, asthma, bronchitis, psoriasis, and pericarditis than population controls. An increased risk for chronic renal disease and multiple sclerosis was noted in UC but not Crohn’s disease patients. The most common nonintestinal comorbidities identified were arthritis and asthma. Conclusions: The finding of asthma as the most common comorbidity increased in Crohn’s disease patients compared with the general population is novel. These may be diseases with common causes or complications of one disease that lead to the presentation with another. Studies such as this should encourage further research into the common triggers in the organ systems that lead to autoimmune diseases.

Section snippets

Data Sources

Data for this study were derived from the Manitoba Health administrative databases. Manitoba Health provides universal health insurance for Manitoba residents that includes coverage for physician and hospital services. Manitoba Health maintains computerized records that are based on the use of health care services by individuals in the province, including admissions to hospitals and physician visits. For each physician service the patient’s identification, the date of service, the diagnosis

Results

There were 8072 patients with IBD who met our administrative definitions from April 1, 1984 to March 31, 2003. This included 4193 patients with Crohn’s disease and 42,405 person-years of observation with disease and 31,365 person-years of observation without disease. There were 3879 patients with UC and 37,335 person-years of observation with disease and 31,904 person-years of observation without disease. There were 6 patients each with Crohn’s disease and UC in whom age-matched, sex-matched,

Discussion

A number of case reports and case series have suggested that the chronic inflammatory diseases we studied are increased in patients with IBD. A recent case-control study was performed at the Mayo Clinic.11 In that study, 243 patients with IBD presenting to the specialty clinic at Mayo Clinic were enrolled over an 8-month period. Controls were identified from outpatients seen at the Mayo Clinic who did not have IBD and were matched to IBD patients by age, sex, and geographic residence. This

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    Supported in part by a Canadian Institutes of Health Research Investigator Award and by a Crohn’s and Colitis Foundation of Canada Research Scientist Award (to C.N.B.).

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