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The following is a summary of “Bronchiectasis In Patients With Inflammatory Bowel Diseases – Prevalence, Predictors, And Clinical Characteristics,” published in the March 2025 issue of CHEST Journal by Freund et al.

BE, a chronic and progressive airway condition, has been increasingly recognized as an extraintestinal manifestation associated with inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis. However, data on its prevalence, risk factors, and clinical characteristics within this population remain limited. This retrospective single-center study aimed to evaluate the prevalence of bronchiectasis among patients with IBD (IBD-BE), identify associated risk factors, and describe the clinical features and management patterns of this comorbidity. The analysis included 1,637 patients who received care at a dedicated IBD unit in a tertiary medical center between 2022 and 2023. Imaging records were reviewed, focusing on prior chest CT scans, which were independently re-evaluated by radiologists blinded to clinical data to confirm the presence of BE. 

Among the cohort, 254 patients had available chest CT scans, and 30 cases of BE were identified, corresponding to 1.8% of the entire IBD cohort. Using multiple imputation techniques to estimate the prevalence across the broader population, the overall prevalence of IBD-BE was calculated at 5.17% (95% CI: 3.60–8.22%). In addition, chest cuts from available abdominal CT scans (n = 1,048) were analyzed, yielding 19 more cases of BE, establishing a conservative minimal prevalence of 3%. Key risk factors significantly associated with IBD-BE included a diagnosis of ulcerative colitis, a history of IBD-related surgical intervention, and the presence of extraintestinal manifestations (EIMs). Notably, 63% of patients with chest CT-confirmed BE already exhibited radiological signs on prior abdominal CTs, highlighting a potential opportunity for earlier identification. Moreover, 70% of those diagnosed with IBD-BE reported respiratory symptoms such as chronic cough or dyspnea, yet the majority had not been referred to a pulmonologist nor received treatment targeted toward BE. 

Clinical presentation and disease trajectory in patients with IBD-BE closely resembled those of patients with non-IBD-related bronchiectasis, suggesting similar pathophysiological and clinical behavior. Despite the presence of suggestive imaging findings and symptoms, there was a significant gap in pulmonology referral and initiation of appropriate respiratory therapy. These findings underscore an under-recognized burden of bronchiectasis in the IBD population and reveal missed opportunities for early detection and management. This study calls attention to the need for heightened clinical awareness, routine screening in patients with symptomatic IBD, and a multidisciplinary approach to care. Early identification of BE in IBD may allow for more effective intervention, potentially mitigating pulmonary complications and improving the quality of life in this at-risk population.

Source: journal.chestnet.org/article/S0012-3692(25)00405-2/abstract