What percentage of patients with Crohn's (Crohn's disease) disease develop Interstitial Lung Disease (ILD)?

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Last updated: March 26, 2025View editorial policy

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From the Guidelines

The prevalence of interstitial lung disease (ILD) in patients with Crohn's disease is estimated to be approximately 0.4% to 3%. This is a relatively uncommon extraintestinal manifestation of Crohn's disease compared to other complications. The development of ILD in Crohn's patients may be related to several factors, including the systemic inflammatory nature of Crohn's disease itself, medication side effects (particularly from medications like methotrexate, sulfasalazine, or anti-TNF agents), or granulomatous inflammation affecting the lungs similar to how it affects the intestines 1.

Key Points to Consider

  • The study from 1 highlights that ulcerative colitis is more likely than Crohn disease to cause respiratory complications, but Crohn's can still lead to ILD.
  • Patients with Crohn's disease who develop respiratory symptoms such as persistent cough, shortness of breath, or decreased exercise tolerance should be evaluated for possible ILD through pulmonary function tests, chest imaging, and sometimes bronchoscopy.
  • Early detection is crucial as management may require adjusting inflammatory bowel disease treatments or adding specific respiratory interventions.
  • It's also important to consider that many of the drugs used to treat inflammatory bowel diseases are known to cause cough by affecting the respiratory system, as noted in the study 1.

Clinical Implications

  • Clinicians should be aware of the potential for ILD in patients with Crohn's disease, especially those presenting with respiratory symptoms.
  • A thorough evaluation, including pulmonary function tests and chest imaging, is necessary for early detection and appropriate management of ILD in Crohn's patients.
  • The relationship between Crohn's disease, its treatment, and the development of ILD should be carefully considered in the management plan, as some treatments may exacerbate or contribute to the development of ILD, as suggested by the findings in 1.

From the Research

Interstitial Lung Disease in Crohn's Disease

  • There is no direct evidence in the provided studies to determine the percentage of patients with Crohn's disease who develop Interstitial Lung Disease (ILD) 2, 3, 4, 5, 6.
  • The studies focus on various aspects of ILD, Crohn's disease, and other conditions, but do not provide a specific percentage or statistic on the co-occurrence of ILD in Crohn's disease patients.
  • Study 3 discusses Crohn's disease in detail, including its characteristics, diagnosis, and management, but does not mention ILD specifically in the context of Crohn's disease.
  • Study 2 provides an overview of ILD, its diagnosis, and treatment, but does not discuss its association with Crohn's disease.
  • Studies 4, 5, and 6 focus on different aspects of ILD and other conditions, but do not provide relevant information on the percentage of Crohn's disease patients who develop ILD.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Infliximab, azathioprine, or combination therapy for Crohn's disease.

The New England journal of medicine, 2010

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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