Association between inflammatory bowel disease and cholelithiasis: A nationwide population-based cohort study

Abstract

We assessed the subsequent risk of cholelithiasis development in patients with inflammatory bowel diseases (IBDs) such as Crohn’s disease (CD) or ulcerative colitis (UC). We identified 8186 patients who aged ≥20 years and were diagnosed with IBD between 2000 and 2010 as the study cohort. A total of 8186 patients without IBD were selected by frequency-matching according to age, sex, comorbidities, and the index date of diagnosis, and they were identified as the control cohort. To measure the incidence of cholelithiasis, all patients were followed up until the end of 2011. The risk of developing cholelithiasis, either gallbladder stone disease (GSD; adjusted hazard ratio (aHR) = 1.76, 95% CI = 1.34-2.61) or common bile duct (CBD) stones and intrahepatic stones (IHSs; aHR = 2.78, 95% CI = 1.18-6.51), was higher for the CD cohort than for the non-IBD cohort after adjusting for age, sex, and comorbidities of hyperlipidemia, diabetes, liver cirrhosis, hypertension, chronic obstructive pulmonary disease, stroke, coronary artery disease, and hepatitis C virus infection. However, UC was related to the development of GSD (aHR = 1.44, 95% CI = 1.19-1.75) but not to CBD stones and IHSs (aHR = 1.70, 95% CI = 0.99-2.91). Our population-based cohort study demonstrated that CD is related to the development of cholelithiasis, including GSD alone and non-GSD-associated cholelithiasis. However, UC is only related to the development of GSD alone.