Spirometry and chest HRCT abnormalities in symptomatic and asymptomatic patients with inflammatory bowel disease

Background: Ulcerative colitis (UC) and Crohn’s disease (CD) are the major subtypes of inflammatory bowel disease (IBD). Lung involvement is an IBD related extra-intestinal manifestations which is poorly studied. Objectives: We aimed to study radiological abnormalities and spirometric findings in symptomatic and asymptomatic patients recently diagnosed with IBD.  Methods: A prospective cross-sectional study enrolled 71 patients (39 (55%) patients with CD and 32 (45%) patients with UC) presented to Main Alexandria University Hospital between 2019 and 2022. Patients were disease-naïve diagnosed by endoscopy. Those with bronco-pulmonary diseases prior to the diagnosis of IBD, cardiac, renal or hepatic diseases were excluded. All patients underwent clinical evaluation, spirometry, and HRCT scan of the chest. Results: The median age of the studied population was 32 (25–37) years being slightly more females (53.5%). Of total population 12 patients (16.9%) were asymptomatic and 59 patients (83.1%) were symptomatic. FEF25-75 and PEFR were significantly lower in the asymptomatic patients (p<0.001 and 0.006 respectively). Further, 7 patients (58.3%) of the asymptomatic group had abnormal HRCT findings where ground glass opacity and bronchiectasis were the frequently reported abnormality without statistically significant difference compared to symptomatic group (p>0.05). Conclusion: Lung involvement in IBD occurs even in asymptomatic population that warrant lung screening with simple tools as spirometry and HRCT scan which can help in early diagnosis and proper management.