Abstract
Both inflammation and infection are associated with the development of irritable bowel syndrome (IBS) and chronic obstructive pulmonary disease (COPD). The purpose of this study is to further elucidate the association between IBS and COPD through a retrospective cohort study. We enrolled IBS patients diagnosed between 2000 and 2011 with follow-up for at least one year. The non-IBS patients as comparison group were selected with 1:3 matching by propensity score. Statistical analysis was utilized to assess the differences in characteristic distribution, and to compare the cumulative incidence of COPD between the IBS and non-IBS cohorts. We selected 14,021 IBS patients and 42,068 non-IBS patients for comparison. The IBS patients exhibited a significant risk to develop COPD compared with non-IBS patients. Additionally, the cumulative incidence rate of COPD in the IBS cohort increased significantly during the follow-up period of more than ten years, compared to the non-IBS cohort, based on the Kaplan-Meier analysis. The risk of COPD was also significantly decreased in those patients with more than eighteen IBS-related clinical visits. This retrospective cohort study demonstrates the significantly increased risk of COPD in patients with IBS. Therefore, early inspection and prevention of COPD is essential for patients with IBS.
Highlights
Both inflammation and infection are associated with the development of irritable bowel syndrome (IBS) and chronic obstructive pulmonary disease (COPD)
The results showed that the IBS cohort presented an increased risk of developing COPD compared to the non-IBS cohort
Previous studies have demonstrated that patients with COPD have an increased risk of IBS19,20, this is the first study using a population-based database to show that IBS potentially increases incidence rates of COPD
Summary
Both inflammation and infection are associated with the development of irritable bowel syndrome (IBS) and chronic obstructive pulmonary disease (COPD). Based on the newest Rome IV system, IBS was diagnosed as recurrent abdominal pain at least 1 day/week on average during the prior 3-month period, with patients exhibiting symptoms including a change of abdominal pain pattern after defecation, and a change in the frequency of stool or the form of stool, based on the Bristol stool form scale[2] These symptoms were generally believed to be related to IBS alone, with no association with any other organic diseases. Several factors have been reported to trigger COPD, including smoking, genetic determinants, cancer growth, infection, environmental stimuli, and progressive immunological disorders[13] Both inflammation and infection models have been utilized in the explorations of IBS and COPD pathophysiology, including investigations into the changes to microbiota, which may play an important role in IBS patients[14]. Is a population-based retrospective cohort study of the Taiwan National Health Insurance Research Database (NHIRD) to investigate the association between IBS and COPD
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