Corticosteroids May Protect Against Asthma-Related Irritable Bowel – (09-06-01)

Corticosteroids May Protect Against Asthma-Related Irritable Bowel

A few things to consider here. The link between asthma and IBS is not all that surprising, except that I personally think they may have it backwards. This and previous studies suggest that patients with asthma are at increased risk of IBS. I would venture to say that it’s the opposite. Patients with GI dysfunction, whether noticed by the patient YET or not, would be more likely to develop asthma. Here’s my scenerio…patient has something happen early in life to disrupt the functional status of the GI tract (antibiotics, bottle feeding…). This ends up leading to a hyper-responsive immune system which in turn can lead to asthma. Then, later in life, the functional changes in the GI tract become noticable by the patient. As for the corticosteroids reducing risk of IBS in asthmatic patients, this gives me concern. Anti-inflammatories and steroids disrupt the integrity of the GI tract, and if the idea of using steroids to cut the risk of IBS gets out, we may be looking at a much larger problem. As the why these researchers found a reduced risk…I would like to see follow up studies confirming the results.

17th annual meeting of the International Conference on Pharmacoepidemiology Asthmatics may have a slightly increased risk of developing irritable bowel syndrome (IBS) compared with the general population. However, those who use oral corticosteroids appear to have slight protection against developing the latter disease, researchers reported here Monday. The finding comes from a study using data from the General Practice Research Database (GPRD) in the UK. The GPRD is a national computerized database of patient records from general practice. It contains more than 35 million patient-years of data and contains long-term information that can be used by researchers. In short, the study findings suggest that asthmatics are 1.3 times more likely to develop IBS than non-asthmatics. A link between the two diseases has been suggested in studies in the past. The results were presented in a poster by researchers from the Centro Español Investigación Farmacoepidemiológica in Madrid, Spain, at the 17th annual meeting of the International Conference on Pharmacoepidemiology here. The prinicipal investigator was Dr. Consuela Huerta. The researchers used information from a random sample of 50,000 database subjects who had a diagnostic code for asthma on January 1, 1994. Patients were included if they were between the ages of 10 and 79 years old. Data for a similar number of age- and sex-matched non-asthmatics were used for comparison. People who had diagnostic codes for IBS, peptic ulcers, cancer, or other confounding conditions were excluded. Both groups of patients were followed until November 1998. Subjects were excluded if during the study period they became pregnant, turned 80 years of age, developed conditions that met the initial exclusion criteria, or were diagnosed with IBS (the endpoint being sought). However, asthmatics who were regularly taking oral corticosteroids at the start of the study were slightly less likely to develop IBS during the study period, compared with other asthmatics. Other asthmatic medications were not associated with any change in IBS risk. However, the data are not strong enough to show whether or not the steroids offer any protective effect, and did not show a difference between long and short-term use of the drugs, Dr. Huerta and colleagues cautioned. Further studies in the general population are necessary to confirm whether the use of corticosteroids, regardless asthma status, has a protective effect against IBS, researchers said.

ations for prevention, given the increasing prevalence of obesity and the morbidity and mortality association with heart defects,” Drs. Watkins and Botto conclude

James Bogash

For more than a decade, Dr. Bogash has stayed current with the medical literature as it relates to physiology, disease prevention and disease management. He uses his knowledge to educate patients, the community and cyberspace on the best way to avoid and / or manage chronic diseases using lifestyle and targeted supplementation.