People with inflammatory bowel disease (IBD) are more likely to have a stroke.
- A study shows that patients with IBD have a 13% increased risk of having a stroke.
- The risk mainly concerns ischemic strokes.
- If this association between IBD and stroke is proven, there is no proof that it is a causal link.
Inflammatory bowel diseases, including Crohn’s disease and ulcerative colitis, can lead to abdominal pain, diarrhea and other bothersome symptoms. However, a new study published in the medical journal Neurology from the American Academy of Neurology suggests that people with IBD also have an increased risk of stroke.
The researchers analyzed data from 85,006 people with IBD, aged 18 to 64, over an average follow-up period of 12 years. During this period, 3,720 of people with IBD had a stroke, compared to 15,599 of people without IBD. This represents a 13% increase in stroke risk over a 25-year period after diagnosis of IBD.
Patients with stroke before diagnosis of IBD excluded from the study
The researchers reviewed records of patients with IBD collected from a health care database in South Korea. Patients with cancer, cardiovascular disease or stroke before their diagnosis of IBD were excluded. Of the remaining patients, those who had a stroke were identified. The researchers compared stroke rates in patients with IBD and in patients without IBD, adjusting for age, sex, smoking, alcohol consumption, body mass index, hypertension, diabetes and bleeding disorders.
An increased risk mainly for ischemic strokes
The researchers also found that the increased risk of stroke in people with IBD mainly relates to ischemic strokes, which are caused by a blockage of blood flow to the brain, rather than hemorrhagic strokes.
The results of this study have important implications for IBD patients and their physicians. Although it does not prove a causal link between IBD and stroke, it does suggest that it is important for patients with IBD to monitor their risk of stroke and take steps to reduce that risk.
Patients with IBD also have conditions that can contribute to strokes
Physicians and patients with IBD should be aware of this increased long-term risk and the need to monitor and manage stroke risk factors. Especially since these patients may have an increased risk of systemic inflammation, vascular problems or bleeding disorders which can all contribute to the risk of stroke.
The researchers stress that additional follow-up studies will be needed to validate these findings and further explore the biological mechanisms underlying this association. Additionally, it will be important to understand how patients with IBD can take steps to reduce their risk of stroke, while managing their underlying bowel disease.
