Release: September 9, 2001
Contact: Kenneth Satterfield(703) 519-1563[email protected]303-228-8460 (9/7-9/12)
UPPER AIRWAY DISORDERS AND INFLAMMATORY BOWEL DISEASE LINKED
Denver, CO-- Medical researchers have determined a rare association between inflammatory bowel disease and obstructing upper airway inflammation. They have observed how symptoms of obstructing laryngotracheitis (inflammation of the trachea and larynx) may present along with the more typical bowel symptoms of ulcerative colitis or Crohn's disease. Painful swallowing, difficulty swallowing, hoarseness, or shortness of breath will be the primary airway complaints, and airway distress rarely can be life threatening. Upper airway examination in these patients will reveal redness, swelling, or ulceration involving any portion of the oral cavity, pharynx, larynx, or trachea. Because biopsies of these lesions show only a non-specific chronic inflammatory response, the diagnosis requires the exclusion of other causes of upper airway inflammation such as cancer or infection.
The authors of the study, "Upper Airway Complications of Inflammatory Bowel Disease," are Larry K. Burton, Jr., MD, and Dana Thompson Link, MD, both from the Department of Otorhinolaryngology and Joseph A. Murray, MD, Division of Gastroenterology and Hepatology, all at the Mayo Clinic, Rochester, MN. Their findings were presented on September 11 at the American Academy of Otolaryngology--Head and Neck Surgery Foundation Annual Meeting/OTO EXPO, being held September 9-12, 2001, at the Colorado Convention Center, Denver, CO.
A retrospective chart review and review of the literature was undertaken by the researchers. The Mayo doctors describe two cases of obstructive upper airway inflammation in patients with ulcerative colitis, one involving the larynx in a 49-year old man, and one occurring in the distal trachea of a 37-year old female. Whereas the first patient was treated successfully with high dose steroids, the second patient required tracheotomy to bypass the narrowed airway segment. Their review of the world's medical literature revealed only 18 prior cases reported over the last 30 years. Their report is intended to heighten physician awareness of the rare link in some patients between obstructing upper airway inflammation and inflammatory bowel disease. Maintenance of the airway is paramount, and a few patients have required emergent endotracheal intubation or tracheotomy. While acute airway inflammation is almost universally reduced with high dose systemic steroids, long-standing, mature, fibrotic stenosis is unyielding to such management, usually requiring careful dilation or stenting. Prognosis is variable, with most patients showing complete resolution with a short course of steroids, while other patients suffer relapses or progressive disease.
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