To estimate prevalence of subclinical airway injuries among IBD patients. To investigate relationship between activity of IBD and airways

Airway diseases are the most commonly described lung manifestations of inflammatory bowel disease (IBD). However, the similarities in disease pathogenesis and the sharing of important environmental risk factors and genetic susceptibility suggest that there is a complex interplay between IBD and airway diseases.Extraintestinal manifestations (EIM) commonly occur in inflammatory bowel diseases (IBD), with a prevalence rate between 21%-41% reported in various series. Crohn's disease (CD) presents with EIM more frequently than ulcerative colitis (UC). Pulmonary involvement complicating IBD was originally considered rare (with a frequency rate < 1%), but the first case series published in 1976 assisted in better recognition, evaluation and description of IBD related respiratory disease. Pulmonary involvement is often asymptomatic and may be detected solely on the basis of abnormal screening tests. This review will focus on the involvement of the airways in the context of IBD. Although IBD related PM were originally considered rare, certain population-based studies have revealed significant interrelationships between the lungs and IBD. Bernstein and colleagues in a large population-based study in North America in 2005 reported that airway disorders in general (including asthma and bronchitis) were the most common extraintestinal manifestation in subjects with CD and the second most common in subjects with UC, with the prevalence of asthma in this population between 7%-8%. In another retrospective study from the opposite view, Birring reported that IBD was 4 times more prevalent among patients with airway diseases, particularly non-asthmatic patients with productive cough, than in the general population.

Inclusion Criteria:

• Patients attended to IBD clinic at Tropical Department

Exclusion Criteria:

1. Age: less than 18 years
2. Unstable patients or need for ICU admission

After taking the informed consent, full history will be taken from all patients participating in the study. Detailed clinical examination and routine laboratory investigations (complete blood count, liver function test, urea, creatinine and ESR) will be done Clinical notes will be obtain and review for all patients with a diagnosis of IBD (history of bowel surgery (for IBD, or indication not stated), use of 5-aminosalicylates or immunomodulators (if indication not stated) ).

Diagnosis of IBD will confirm on the basis of a consistent clinical picture with endoscopic and histological confirmation, or characteristic radiological appearances.

Airways disease will classify on the following grounds: asthma,.COPD:,Bronchiectasis,.Chronic bronchitis: