Patterns of airway involvement in inflammatory bowel diseases

Table 1 Classification of airway diseases secondary to inflammatory bowel diseases[1,3,4]

Site of involvement	Manifestations	Percent of total PM
Upper extrathoracic and intrathoracic airways (larynx/glottis, trachea, mainstem bronchi)	Stenoses, tracheobronchitis, acute respiratory failure	7%-8%
Large airways	Bronchiectasis	23%-26%
	Simple chronic bronchitis without suppuration	10%-20%
	Mucoid impaction
	Bronchial granulomas
	Suppurative bronchitis	3%-8%
Small airways	Granulomatous bronchiolitis	3%-10%
	Acute bronchiolitis
	Diffuse panbronchiolitis
	Bronchiolitis obliterans syndrome
Concomitant diseases involving the airways	Asthma
	Chronic obstructive pulmonary disease
	Sarcoidosis
	A1 antitrypsin deficiency

PM: Pulmonary manifestations.

Table 2 Key messages

In a patient with IBD and respiratory symptoms, symptoms should be initially attributed to the primary disease because of significant lung-intestine interference

IBD, asthma and COPD often coincide

IBD should be always remembered in the differential diagnosis of bronchiectasis and bronchiolitis

PFT and HRCT are necessary to evaluate a symptomatic patient

IBD related airway disease does not necessarily follow the course of colitis

IBD: Inflammatory bowel disease; COPD: Chronic obstructive pulmonary disease; PFT: Pulmonary function tests; HRCT: High resolution computed tomography.