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IBD and Asthma: What’s the Connection With Crohn’s and Colitis?

Posted on November 15, 2021
Medically reviewed by
Steven C. Pugliese, M.D.
Article written by
Imee Williams

Asthma is known to have several comorbidities, or co-occurring conditions. Recent research suggests that asthma may be linked to an increased risk of inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis. Crohn’s disease can affect the entire digestive tract, from the mouth to the anus, and ulcerative colitis mainly impacts the colon.

IBD is an autoimmune disease, or a condition that causes the immune system to attack the body’s healthy tissues. In IBD, the digestive tract is chronically inflamed. This inflammation leads to gastrointestinal symptoms like diarrhea, abdominal pain, rectal bleeding, bloody stools, weight loss, and fatigue. Asthma affects the respiratory tract and can cause coughing, wheezing, shortness of breath, and chest tightness. These symptoms may make it difficult for people with asthma to breathe and perform daily activities.

Although asthma and IBD affect the body in different ways, they share genetic and environmental risk factors.

What’s the Association Between Asthma and IBD?

Recent studies have discovered that asthma and IBD frequently co-occur and may be caused by similar factors.

Genetics

Studies have found up to 23 mutated genes associated with multiple inflammatory diseases, including asthma and IBD. The majority of these genes help maintain the immune system and immune response.

Variations of specific genes that help maintain the epithelial cell barrier have increased prevalence in people with asthma, Crohn’s disease, and ulcerative colitis. Epithelial cells surround the lungs and digestive tract, protecting the body from toxins, viruses, or environmental allergens. The underlying reason why this genetic variation increases a person’s susceptibility to inflammatory diseases remains unknown.

Age

One study found a link between asthma and ulcerative colitis that was dependent on the age at which ulcerative colitis was diagnosed. Researchers discovered that people diagnosed with ulcerative colitis between 3 and 16 years of age or after 40 years of age tended to have a preexisting asthma diagnosis. However, those diagnosed between 17 and 40 years of age often had no preexisting asthma diagnosis. The researchers found that an asthma diagnosis was not an age-dependent factor for Crohn’s disease, however.

Decreased Immunity

The “hygiene hypothesis” is a theory that supports the connection between asthma and IBD. This theory suggests that children who grew up in a more sterile environment are at a higher risk of developing immune-mediated conditions such as asthma or IBD later in life.

Common Risk Factors and Triggers

Both IBD and asthma share other risk factors that may help explain the connection between the conditions. Studies have found the relationship may be caused by interactions among a person’s family history or genetic makeup, intestinal microbiome, and environmental risk factors. Specifically, these risk factors can include:

  • Exposure to antibiotics
  • Having an appendectomy
  • Exposure to air pollution
  • Cigarette smoking and exposure to secondhand smoke
  • Taking nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Physical and emotional stress

It is unclear whether asthma precedes IBD or if IBD comes before asthma. Further research needs to be done to understand how genetic susceptibility, family history of disease, environmental exposures, and the gut microbiome may influence asthma and IBD.

Living With Asthma and IBD

Many people living with IBD can also develop other lung diseases aside from asthma. Studies have found that IBD is four times more prevalent in people with airway diseases like bronchitis (inflammation of airways) and chronic cough.

Although there is not yet a cure for asthma or IBD, there are many ways to manage and reduce symptoms. These strategies include avoiding triggers, taking medications, and reducing stress in your life.

Avoiding Triggers

Asthma and IBD have similar triggers. Not everyone experiences the same triggers, so it is important to take the necessary steps to identify your triggers. By doing so, you can better avoid those triggers and help prevent the worsening of your asthma and IBD symptoms.

Speak to a doctor right away if you begin to experience IBD symptoms. Your health care provider can refer you to a specialist, such as a gastroenterologist, who can help treat your IBD as well.

IBD Management

It is important to manage IBD to stay at your healthiest, feel your best, and improve your quality of life.

Over-the-counter and prescription medications are available to help manage IBD symptoms. These medications include:

  • Aminosalicylates
  • Biologics
  • Antibiotics
  • Immunomodulators
  • Corticosteroids
  • Antidiarrheal medication
  • NSAIDs
  • Vitamins and probiotics

In severe cases, surgery for ulcerative colitis or Crohn’s disease may be necessary.

Asthma Medications

Over-the-counter and prescription medications are available to help manage asthma symptoms, including corticosteroids, inhaled medications, allergy medications, and others.

Read more about treatments for asthma.

Stress Reduction

Reducing physical and emotional stress has been shown to improve asthma and IBD symptoms in some people. Several ways to decrease stress include:

  • Reducing or quitting smoking
  • Getting regular exercise
  • Practicing relaxation techniques
  • Getting adequate sleep
  • Eating a healthy diet
  • Going to counseling

Talk With Others Who Understand

On MyAsthmaTeam, more than 7,100 members come together to ask questions, give advice, and share their stories with others who understand life with asthma.

Do you have asthma and IBD? What tips can you offer? Share your experience in the comments below, or start a conversation by posting on MyAsthmaTeam.

All updates must be accompanied by text or a picture.
Steven C. Pugliese, M.D. is affiliated with the Hospital of the University of Pennsylvania in Philadelphia, serving as the director of the pulmonary embolism response team, co-director of the comprehensive pulmonary embolism program, and an assistant professor of clinical medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Imee Williams is a freelance writer and Fulbright scholar, with a B.S. in neuroscience from Washington State University. Learn more about her here.

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