Chronic Rhinosinusitis Closely Associated with Inflammatory Bowel Disease in Adults, States study

A recent study published in the International Forum of Allergy & Rhinology found a significant link between chronic rhinosinusitis (CRS) and inflammatory bowel disease (IBD), including its subtypes ulcerative colitis (UC) and Crohn's disease (CD). The study analyzed data from the U.S. Collaborative Network using the TriNetX Analytics platform and revealed that individuals with IBD are four times more likely to develop CRS when compared to the individuals without IBD. Similarly, patients with CRS were found to be over 4 times more likely to develop IBD, with a slightly higher risk observed for UC than CD.

The study involved 6 patient groups, including the individuals with and without IBD, UC, CD, and CRS. The findings indicated that individuals with UC had a 4.26-fold increased risk of developing CRS, while the individuals with CD had a 3.45-fold increased risk. Also, CRS patients had a 4.48-fold increased risk of developing UC and a 3.56-fold increased risk of developing CD. These results suggest a stronger association between UC and CRS when compared to CD. The study also examined the temporal relationship between these conditions that revealed IBD patients to be 5 times more likely to develop CRS than CRS patients are to develop IBD. This study adds to a growing body of literature that explores the relationship between CRS and IBD. Previous studies, including one from 2021 in Taiwan, have also reported a higher risk of CRS development following IBD diagnosis. These findings are consistent with the increased risk of CRS among UC patients when compared against CD patients.

The pathophysiology of both CRS and IBD is believed to involve epithelial barrier disruption, which leads to chronic inflammation. In CRS, architectural changes in the sinus epithelium allow pathogens to penetrate, in turn triggering an immune response. Thereby, a defective intestinal barrier in IBD patients could facilitate the entry of pathogens into the intestinal walls by contributing to inflammation. Other shared mechanisms in the pathophysiology of CRS and IBD include dysregulation of the immune system, imbalances in microbial composition, and the gut-lung axis, which allows the migration of bacteria between the gut and sinuses.

The findings of this study underlines the importance of understanding the potential overlapping etiological relationship between these conditions. Further research is imperative to explore factors such as the role of medications and other underlying mechanisms that may contribute to the co-prevalence of CRS and IBD. Overall, this research provides valuable insights for clinicians in managing patients with these chronic inflammatory diseases and highlight the need for continued investigation.

Source:

Dhamija, R., Ding, P., Das, N., Shah, V. N., Kaelber, D. C., & Chaaban, M. R. (2024). Co‐prevalence of chronic rhinosinusitis and inflammatory bowel disease: A large aggregated electronic health record study. In International Forum of Allergy & Rhinology. Wiley. https://doi.org/10.1002/alr.23425