New study highlights link between IBD and increased risk of stroke

Suffering from an inflammatory bowel condition such as Crohn’s disease or ulcerative colitis, could increase the risk of having a stroke in later life, according to a new study.

Research published in the online journal Neurology suggests that those with inflammatory bowel disease are 13% more likely to have a stroke up to 25 years after their diagnosis than those without IBD.

The study doesn’t prove that IBD causes a stroke. But the team behind the study said it highlights a link between the two health issues and highlights that screening and management of stroke risk factors could be more urgent in people who have Crohn’s, ulcerative colitis, and unclassified inflammatory bowel disease.

Study author, Dr Jiangwei Sun, of the Karolinska Institutet in Stockholm, Sweden, said: “These results show that people with inflammatory bowel disease and their doctors should be aware of this long-term increased risk.

“Screening and management of stroke risk factors may be more urgent in people with IBD.”

More than 85,006 people with IBD confirmed with a biopsy were involved in the study. They were each matched with up to five people of the same birth year, sex and county of residence who did not have IBD. In total, 406,987 people were involved in the research.

During an average follow-up of 12 years, 3,720 of the people with IBD had a stroke, compared with 15,599 of those who didn’t have an inflammatory bowel disease. This is a rate of 32.6 per 10,000 person years for those with IBD compared to 27.7 for those without.

Person-years represent both the number of people in the study and the amount of time each of them spends participating in the research.

When researchers accounted for other factors that could affect stroke risk, such as heart disease, high blood pressure and obesity, they found that people with IBD were 13% more likely to have a brain attack than those without.

Researchers found that the increased risk was mainly due to ischemic stroke, which is caused by a blockage of blood flow to the brain, rather than haemorrhagic stroke, which occurs as a result of bleeding in or around the brain.

Because both inflammatory bowel disease and stroke have some genetic components predisposing people to the disease, researchers also included in the study full siblings of the people with IBD.

The 101,082 siblings had no history of IBD or stroke at the beginning of the study. Consistent with the main results, people with IBD had a higher risk of stroke than their siblings not suffering from the disease. Their overall risk was 11% higher.

Dr Sun said: “The elevated risk for people with IBD remained even 25 years after they were first diagnosed, corresponding to one additional stroke case for every 93 people with IBD until that point,”

A limitation of the study was that the criteria for diagnosing inflammatory bowel disease and stroke have changed, which the research team admitted could affect the results.

Also, researchers did not have complete information on all factors that could affect stroke risk, such as diet, smoking and alcohol consumption.

Crohn’s disease is a long-term condition that can affect anyone of any age which is caused by inflammation of the lining of the digestive system.

Symptoms can include recurring diarrhoea, abdominal pain and cramping which is usually worse after eating, unintended weight loss, extreme tiredness, and blood and mucus when a stool is passed.

Ulcerative colitis is a long-term condition affecting the colon and rectum. It causes inflammation in the colon as well as ulcers in the lining of the large bowel which can bleed and produce pus.

Sufferers can experience mouth ulcers, painful and swollen joints, irritated and red eyes, patches of inflamed skin, as well as weight loss, tiredness and loss of appetite.

Neither Crohn’s disease or ulcerative colitis are currently curable.