Pulmonary complications of inflammatory bowel disease: focus on management issues

Pulmonary complications of inflammatory bowel disease (IBD) have been increasingly recognized and reported in the literature. The complications can involve the lung parenchyma, pleural space, and small or large airways. Although the mechanism of pulmonary involvement in IBD is not clearly understood, there are pathological similarities between the disease seen in the lungs and that in the bowel. Accurate diagnosis involves a combination of patient history, symptom review, thoracic imaging modalities, and bronchoscopic evaluation. We will summarize the various IBD-associated pulmonary complications, and specifically focus on reviewing the airway manifestations that have been reported. Endoscopic management strategies which include rigid or balloon dilatation, laser therapy, electrocautery, argon plasma coagulation, and stent placement will be described.