Pulmonary involvement and allergic disorders in inflammatory bowel disease
Nikolaos E Tzanakis, Ioanna G Tsiligianni, Nikolaos M Siafakas
World J Gastroenterol 2010 January 21; 16(3): 299-305

Abstract
Inflammatory bowel disease (IBD) has been asso ciated with either clinical or subclinical airway and parenchymal lung involvement and interstitial lung complications. Several studies have reported that atopy has a high prevalence in IBD patients. Overlapping allergic disorders seem to be present in both the respiratory and gastrointestinal systems. The purpose of this review is to update clinicians on recent available literature and to discuss the need for a highly suspicious approach by clinicians.

CONCLUSION
Three patterns of pulmonary involvement have been reported to accompany IBD: (1) airway disease includ ing large airway stenosis, chronic bronchitis, small airway dysfunction, severe bronchial suppuration and bronchiectasis; (2) parenchymal lung involvement either as subclinical lymphocytic alveolitis or several types of pulmonary infiltrate such as granulomatous bronchiolitis and bronchiolitis obliterans; and (3) a reduction in the diffusing capacity of the lung is a well established abnormality of pulmonary function testing in some patients with IBD.
We propose that patients suffering from IBD should undergo pulmonary evaluation which should include physical examination, chest X-ray and pulmonary function testing with DLCO measurement. This pulmonary evaluation may be useful in detecting subclinical or clinical pulmonary involvement in IBD patients or as a baseline evaluation. In clinical cases with pulmonary manifestations, inhaled or systemically administered steroids appear to be an effective treatment. With regard to atopy, routine investigations should be considered, at least in patients with IBD who also present with airway dysfunction.

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