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P056. Pulmonary function tests in patients with ulcerative colitis

L. Lazebnik, S. Mikhaylova, A. Parfenov, I. Ruchkina, V. Rogozina, O. Knyazev

Central Scientific Research Institute of Gastroenterology, Moscow, Russian Federation

Pulmonary involvements in patients with IBD are less studied and information of pulmonary dysfunction in IBD is inconsistent.

The aim: To evaluate the frequency and type of pulmonary dysfunctions in patients with different clinical course of ulcerative colitis (UC), their relation to the duration of the disease and to tobacco smoking.

Subjects and Methods: 164 patients with UC were observed. Diagnosis was confirmed by clinical, laboratorial and instrumental studying methods.

The median age was 44.6 years (range 17–72 years), smokers and ex-smokers were 73 patients. The onset of UC was at least 42 years ago. All patients with UC and 60 healthy matched for age, sex and smoking habit (a control group) underwent spirometry (Eton, RF). Analyzed parameters: VC, FVC, FEV1, PEF, FEF25, FEF50, FEF75. We analyzed the history of UC, extent of intestinal lesions by colonoscopy, clinical activity (Rachmilevitz) and severe course (Truelov) of UC. From the study were excluded the patients who had chronic diseases of the respiratory system before UC and patients who were treated with beta-blockers.

Results: Lung function abnormalities were found in 5 healthy subjects (8.3%) and in 72 patients with UC (43.9%, p < 0.001). 57 patients with UC were predominantly obstructive pattern of small airways (decrease of FEF50 and FEF75 <60% of predicted value (p.v.)), 5 patients had restrictive pattern (decrease of VC < 80% of p.v.) and 10 patients had restrictive-obstructive pattern. Abnormal spirometry was observed in 16 patients (42.1%) out of 37 with newly diagnosed UC, who were not treated yet. In patients with history of UC > 10 years (n = 28) the pulmonary dysfunction was found more frequently than in patients with duration of UC <10 years (n = 98): in 89.3% and in 31.6% respectively (p < 0.005). Lung function abnormalities in patients with distal colitis (n = 47) were found significantly less (25.5%) than in patients with subtotal (n = 53) and total (n = 62) colitis (50.9% and 51.6% respectively, p < 0.05). The changes in pulmonary function were observed in 18 patients (72.0%) out of 25 with chronic continuously form of UC, in 16 patients (42.1%) out of 38 with first attack of UC (p < 0.05) and in 38 patients (37.6%) of 101 with chronic relapsing form of UC (p < 0.005). Abnormal spirometry was observed in patients with a severe attack of UC (n = 18) significantly higher (by 72.2%) that in patients with mild attack of UC (n = 53) – by 26.4% (p = 0.001). The frequency of pulmonary function disorders in smokers and ex-smokers was insignificantly higher than in nonsmokers (50.7% and 38.5% respectively, p = 0.2).

Conclusion. Pulmonary dysfunction was significantly more frequent in patients with UC than in control (p < 0.001), which was represented predominantly as obstruction of small airways. These findings didn't correlate to tobacco smoking. The pulmonary function abnormalities in the patients with new onset of the disease, who were not treated yet, aren't related to drug use and therefore can manifest the pulmonary involvement of UC.