IBD: The gut problem that increases stroke risk

A growing body of evidence shows just how closely linked gut health is with our overall well-being. That’s why when the balance of our intestinal tract is upset by something like inflammatory bowel disease (IBD), it can spell trouble for many other systems within the body.

For instance, people with IBD are at higher risk of colorectal cancer and prostate cancer. They have triple the risk of developing blood clots. Their risk of heart attack is up to nine times higher than that of people without IBD. And they’re more than twice as likely to develop dementia.

For these reasons, and the one I’m about to share, it’s incredibly important to manage IBD well…

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IBD could increase stroke risk

In a new study, researchers studied 85,006 people with IBD confirmed by biopsy. For comparison’s sake, the IBD patients were matched up to five people of the same birth year, sex and county of residence who did not have IBD. This brought the total to 406,987 participants.

The average follow-up was 12 years. During that time, 3,720 of the IBD patients had a stroke, compared with 15,599 of the people who did not have IBD.

The researchers then identified other factors that could affect stroke risks, such as heart disease, high blood pressure and obesity. When accounting for those factors, they found people with IBD were 13 percent more likely to have a stroke up to 25 years after their diagnosis than those without the disease.

This increased risk was mainly due to ischemic stroke caused by a blockage of blood flow to the brain, rather than hemorrhagic stroke caused by bleeding in the brain.

Both IBD and stroke have genetic components that predispose some people to the disease. For that reason, the researchers also included full siblings of the participants with IBD in the study. These 101,082 siblings had no history of IBD or stroke at the beginning of the study.

When compared with their siblings, the participants with IBD had an 11 percent higher overall risk of stroke.

Now, the researchers caution that this study only shows an association between IBD and stroke. It doesn’t prove that IBD causes stroke.

Still, study author Dr. Jiangwei Sun of the Karolinska Institutet in Stockholm says the results show people with IBD and their doctors need to be aware of this long-term increased risk. “Screening and management of stroke risk factors may be more urgent in people with IBD,” Sun says.

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Steps to lower your odds of stroke

If you have IBD, take extra care to protect yourself against preventable risk factors for stroke. You’ll definitely want to avoid smoking, and it’s probably also a good idea to skip alcohol use as well. And make sure you manage your blood pressure, cholesterol and blood sugar levels, as high blood pressure, elevated cholesterol and diabetes can all contribute to stroke risk.

It’s also a good idea to pay attention to risk factors for blood clots, especially since the strokes recorded in the study tended to be caused by a blood flow blockage. Blood clot risk factors in those with IBD include:

• IBD flare-ups 
• Hospitalization (especially due to an IBD flare)
• Surgery
• Increasing age
• Pregnancy 
• Medications (including steroids used to treat inflammation associated with IBD)

Above all, talk to your doctor to see what you can do to manage your IBD, reduce your risk of blood clots and maintain healthy blood flow. If necessary, they can adjust your medication to help reduce your IBD flare-ups and protect you against clots.

There are steps you can take as well to help your IBD. One of the most important is to eliminate any IBD triggers in your diet. My colleague Dr. Adria Schmedthorst recommends a plant-based diet free from animal products and processed foods, which in one case study sent a patient’s Crohn’s disease into complete remission.

Adding mango to your diet is another good way to reduce your IBD symptoms, as long as you do it gradually to minimize any issues with its fiber.

To support normal blood flow, make sure you exercise regularly and add certain nutrients to your diet, including vitamin K2 and an enzyme called nattokinase found in fermented soy. Natto, a dish made from fermented soybeans, contains both these important nutrients to help promote healthy circulation.

Sources:

Inflammatory bowel disease linked to increased risk of stroke — EurekAlert!

Stroke Causes and Risk Factors — National Heart, Lung, and Blood Institute