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Purpose of Review <p>To provide a clinically oriented synthesis of the epidemiology, pathophysiology, and management of bronchiectasis in patients with inflammatory bowel disease (IBD), and to clarify the key mechanisms underlying this association.</p> Recent Findings <p>Emerging evidence suggests a non-random association between IBD and bronchiectasis, with prevalence estimates varying widely according to study design and diagnostic approach. Mechanistic insights support a role for gut–lung axis dysfunction, including loss of mucosal tolerance, microbial dysbiosis, and immune cell trafficking. Clinically, bronchiectasis in IBD appears heterogeneous and may occur independently of intestinal disease activity. The increasing use of biologic therapies further complicates management, particularly regarding infection risk.</p> Summary <p>Bronchiectasis should be recognised as a relevant extra-intestinal manifestation of IBD with important implications for diagnosis and management. A pragmatic, multidisciplinary approach is required, and further research is needed to define optimal screening strategies and tailored therapeutic pathways.</p> Take Home Message <p>Bronchiectasis is a frequent but under-recognized extra-intestinal manifestation of IBD. Awareness of the gut–lung axis and early multidisciplinary management are essential to balance inflammation control, infection risk, and respiratory outcomes in the era of biologic therapies.</p>

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Managing the Overlap: Bronchiectasis and Inflammatory Bowel Disease in the Era of Precision Medicine

  • 期刊论文

  • 发表日期：

    2026年5月7日

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  • Chiara Contin,
  • Alessandro De Angelis,
  • Mattia Nigro,
  • Edoardo Simonetta,
  • Dan Padawer,
  • Veronica Polelli,
  • Anna Stainer,
  • Paola Scarano,
  • Francesco Blasi,
  • Andrea Gramegna,
  • Gianluca Franchellucci,
  • Cristina Bezzio,
  • Alessandro Armuzzi,
  • Sara Onali,
  • Paolo Spagnolo,
  • Stefano Aliberti

摘要

Purpose of Review

To provide a clinically oriented synthesis of the epidemiology, pathophysiology, and management of bronchiectasis in patients with inflammatory bowel disease (IBD), and to clarify the key mechanisms underlying this association.

Recent Findings

Emerging evidence suggests a non-random association between IBD and bronchiectasis, with prevalence estimates varying widely according to study design and diagnostic approach. Mechanistic insights support a role for gut–lung axis dysfunction, including loss of mucosal tolerance, microbial dysbiosis, and immune cell trafficking. Clinically, bronchiectasis in IBD appears heterogeneous and may occur independently of intestinal disease activity. The increasing use of biologic therapies further complicates management, particularly regarding infection risk.

Summary

Bronchiectasis should be recognised as a relevant extra-intestinal manifestation of IBD with important implications for diagnosis and management. A pragmatic, multidisciplinary approach is required, and further research is needed to define optimal screening strategies and tailored therapeutic pathways.

Take Home Message

Bronchiectasis is a frequent but under-recognized extra-intestinal manifestation of IBD. Awareness of the gut–lung axis and early multidisciplinary management are essential to balance inflammation control, infection risk, and respiratory outcomes in the era of biologic therapies.