Briefs

People With IBD More Likely to Suffer Respiratory and Nerve Disorders

BETHESDA, Md. –– According to two studies published in the American Gastroenterological Association (AGA) journal Gastroenterology, people with inflammatory bowel disease (IBD) are more prone to developing severe disorders of the respiratory and nervous systems. The studies found an increase in the prevalence of asthma, arthritis, chronic renal disease, multiple sclerosis and psoriasis, among other disorders.

“These studies remind us that the effects of inflammatory bowel disorders extend to every corner of the body, including the lungs and central nervous system,” said Edward V. Loftus, Jr., MD, author of an editorial appearing in the journal and associate professor of medicine at the Mayo Clinic College of Medicine. “The findings lend credence to the concept that patients with one chronic inflammatory condition are more likely than the general population to develop another.”

IBD refers to both ulcerative colitis and Crohn’s disease. There are more than two million prevalent cases of Crohn’s disease and more than one million cases of ulcerative colitis in the U.S.

The findings from the second study “highlight an often overlooked association between intestinal disorders and the respiratory system,” said Loftus. “Long-term consequences of untreated pulmonary involvement in IBD are substantial and physicians should at least follow up respiratory complaints with pulmonary function tests.”

Source: American Gastroenterological Association

Women who took two or more aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) per week for more than 10 years significantly reduced their risk of colorectal cancer, according to an article in the Journal of the American Medical Association (JAMA).

Recent randomized intervention trials have demonstrated that regular use of aspirin in patients with a history of colorectal adenoma (benign tumor) or cancer reduces the risk of recurrent adenoma within one to three years, according to background information in the article. However, whether long-term use of aspirin similarly reduces the risk of colorectal cancer and, if so, at what dose, has been unclear.

Andrew T. Chan, MD, MPH, of Massachusetts General Hospital and Harvard Medical School, Boston, and colleagues examined the influence of aspirin and NSAIDs on the risk of colorectal cancer in 82,911 women. The subjects, enrolled in the Nurses’ Health Study, have been providing data on medication use biennially since 1980 and followed up through June 1, 2000.

Over the 20-year period, 962 cases of colorectal cancer were documented. Among women who regularly used aspirin (two or more standard [325-mg] tablets per week), there was a 23 percent reduced relative risk for colorectal cancer compared with nonregular users. However, significant risk reduction was not observed until more than 10 years of use. The benefit appeared related to dose; compared with women who reported no use, the relative risk for cancer was 10 percent greater for women who used 0.5 to 1.5 standard aspirin tablets per week;

11 percent lower with two to five aspirins per week; 22 percent lower with six to 14 aspirins per week; and 32 percent lower with more than 14 aspirins per week. Women who took more than 14 aspirins per week for longer than 10 years had a 53 percent lower relative risk for colorectal cancer. A similar dose-response relationship was found for non-aspirin NSAIDs.

“Our study supports a possible role for aspirin in cancer prevention, which has been demonstrated by prior adenoma recurrence trials. However, any substantial impact of aspirin on cancer necessitates early initiation and prolonged, consistent use.

Moreover, optimal chemoprevention may require substantially higher doses of aspirin than currently recommended for the prevention of cardiovascular disease. Many toxicities of aspirin, including gastrointestinal bleeding, are dose-dependent. Thus, future studies will need to thoroughly consider the risk-benefit profile for aspirin/NSAID chemoprevention among various risk groups and compare such a strategy with other potential prevention efforts,” the authors concluded. The article can be found in JAMA. 2005; 294:914-923.

Source: American Medical Association

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