S1607 Higher Frequency of Respiratory Symptoms Are Reported Among Patients With Crohn’s Disease Compared to Patients With Ulcerative Colitis

Introduction: Thirty percent to 50% of patients with inflammatory bowel disease (IBD) present with extraintestinal manifestations (EIMs). Thus far, pulmonary manifestations of IBD have been underexplored. This study investigates the clinical presentation of pulmonary EIMs by comparing respiratory symptom presentation between individuals with Crohn’s disease (CD) and those with ulcerative colitis (UC). Methods: We performed a systematic review and meta-analysis of studies that reported respiratory symptoms in adult patients with IBD. We included cohort, randomized control trial, cross-sectional, and case-control study designs. This included 9 cohort studies, 2 cross-sectional studies, and 5 case-control studies. Primary outcomes such as respiratory symptoms, cough, wheezing, and dyspnea were compared between patients with CD and patients with UC. Chi-square analysis was performed to compare prevalence of symptoms across groups. Percentages were calculated out of the total number of patients in studies that reported each symptom. Results: 8132 patients with IBD were included in this study, including 795 (9.8%) patients with CD and 7337 (90.2%) patients with UC. Because controls were selected for their healthiness, they were not included in this analysis. Patients with CD were significantly more likely to report respiratory symptoms – over 30 percent of patients with CD endorsed respiratory symptoms, compared to 9.8 percent of patients with UC (P < 0.0001). Patients with CD were more likely to report any cough (135 (21.7%) vs 205 (14.9%), P = 0.0002) and dyspnea (111 (19.1%) vs 432 (6.8%), P < 0.0001). Patients with UC were more likely to report wheezing (49 (29.7%) vs 63 (19.5%), P = 0.0113). No significant differences were noted between diagnoses when cough was disaggregated by nonproductive vs productive (P = 0.47 and P = 0.09 respectively). Conclusion: Patients with CD are more likely to experience respiratory symptoms than patients with UC, particularly cough and dyspnea. However, both groups experience respiratory symptoms although their symptom profiles may differ. Providers taking care of patients with IBD should inquire about respiratory symptoms and consider further work-up if present.