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Celiac Disease and Chronic Obstructive Pulmonary Disease (COPD)

Celiacs at Higher Risk for COPD Before, After Diagnosis

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Updated September 26, 2011

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It's not infrequent to find someone with celiac disease who also has asthma. But it also appears that people with celiac disease may be at moderately increased risk for another respiratory disorder: chronic obstructive pulmonary disease, or COPD.

COPD, a lung disease, progressively makes it harder for you to breathe as your airways lose their elasticity and their walls thicken, becoming inflamed and clogged with mucus.

Most COPD cases involve current or former smokers. In addition, the condition can affect people who have had long-term exposure to other airborne lung irritants, including pollution and secondhand smoke.

And, it appears that people with celiac may develop COPD more frequently than the general population.

Emphysema, Chronic Bronchitis Forms of COPD

The National Institutes of Health recognizes two forms of COPD: emphysema and chronic bronchitis.

In emphysema, the walls that separate the air sacs in your lungs become damaged over time. Eventually, they lose their shape and may even break down, leaving fewer, larger air sacs that don't work as well to allow oxygen exchange from your lungs into your bloodstream.

In chronic bronchitis, meanwhile, you have chronic inflammation and irritation in your airways, which causes their linings to thicken. In addition, too much mucus fills the tiny passages, making it more difficult for you to breathe.

Most people are diagnosed with COPD in middle age or in their senior years. The condition progresses slowly, but eventually many people need supplemental oxygen. COPD represents the third-leading cause of death in the United States, behind only heart disease and cancer.

Study Shows Increased COPD Risk for Celiacs

There are few medical studies on COPD risk in celiac disease, but the available research indicates there is an increased risk.

A team of researchers in Sweden used that country's excellent national health database to identify all people with biopsy-proven celiac disease who had been diagnosed between 1987 and 2008. They found 10,990 individuals and matched them with 54,129 control subjects without celiac. They then looked to see how many had been diagnosed with COPD.

A total of 3.5% of individuals with celiac disease also had been diagnosed with COPD, compared with 2.6% of the control subjects, indicating about a 25% increase in risk for COPD if you have celiac disease.

The risk dropped somewhat after people were diagnosed with celiac disease, but still remained higher than normal in the five years following their celiac disease diagnoses.

Heightened Risk Could Relate to Inflammation, Nutritional Status

It's not clear why people with celiac disease might have an increased risk for COPD.

The authors of the Swedish study noted that chronic inflammation plus poor nutritional status can influence the development of chronic obstructive pulmonary disease. Since celiac disease "is characterized both by dysregulated inflammation and malnutrition," they said, they decided to investigate if there was an association.

Other researchers, citing case reports, also have noted a possible association between the two conditions.

Does celiac disease cause COPD? No, most people develop COPD because they smoked or were exposed to secondhand smoke. However, having celiac disease,whether it's diagnosed or not, might increase your chances of developing COPD as you get older, especially if you have other risk factors for the lung illness.

Sources:

De Menthon M. et al. Undiagnosed coeliac disease in patients with emphysema: a fortuitous association? European Respiratory Journal. 2010 Aug 1. 36(2):453-6.

Ludvigsson J.F. et al. A nationwide cohort study of the risk of chronic obstructive pulmonary disease in coeliac disease. Journal of Internal Medicine. 2011 Aug 31. doi: 10.1111/j.1365-2796.2011.02448.x (Epub ahead of print)

National Heart, Lung and Blood Institute. What is COPD? Accessed Sept. 21, 2011.

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