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• Posted June 15, 2023

Inflammatory Bowel Disease Tied to Higher Odds for Stroke

Having inflammatory bowel disease, or IBD, could mean having a higher long-term risk of stroke, according to a new study.

People with IBD are 13% more likely to have a stroke up to 25 years after their diagnosis than those without the condition, the researchers found. Their report was published June 14 in the journal Neurology.

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

“Screening and management of stroke risk factors may be more urgent in people with IBD,” Sun added in a journal news release.

The findings don't prove that IBD causes this serious outcome, only that there is an association.

Types of IBD include Crohn's disease, ulcerative colitis and unclassified inflammatory bowel disease, causing chronic inflammation of the intestines.

The study included more than 85,000 people who had their IBD confirmed by biopsy. Each was matched with up to five people of the same age, sex and county of residence who did not have IBD. There were nearly 407,000 people in the control group.

Among the study participants, 3,720 of those with IBD had a stroke during the average follow-up of 12 years. That was compared to 15,599 of those without IBD who had a stroke and were from the much larger group.

The stroke rate was 32.6 per 10,000 person-years for those with IBD compared to 27.7 for those without IBD. Person-years represent both the number of people in the study and the amount of time each person spends in the study.

The increased risk was mainly in ischemic stroke, the most common type, which is caused by a blockage of blood flow to the brain. Hemorrhagic stroke is caused by bleeding in the brain.

Both IBD and stroke have some genetic components predisposing people to the disease, the study authors noted. For this reason, the study also included full siblings of the people with IBD. The more than 101,000 siblings had no history of IBD or stroke when the study began.

Those with IBD still had a higher risk of stroke than their siblings without IBD. Their overall risk was 11% higher.

“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,” Sun said.

The criteria for diagnosing IBD and stroke has changed over the years, which could affect the results, the authors cautioned. Also, the data did not include complete information on all factors that could affect stroke risk, such as diet, smoking and alcohol consumption, which was a study limitation.

More information

The U.S. Centers for Disease Control and Prevention has more on inflammatory bowel disease.

SOURCE: Neurology, news release, June 14, 2023