The Bidirectional Relationship between IBS and Alopecia Areata
Alopecia areata (AA) and irritable bowel syndrome (IBS) are two distinct diseases that share a similar pathophysiology; however, the relationship between these two diseases is not fully understood.
In 2017, Conic and colleagues set out to retrospectively review the clinical features of patients with alopecia areata that were seen at the Cleveland Clinic from 2005 to 2014. In total, data from 504 patients was tabulated, and as a comparison group, 172 patients with seborrheic dermatitis were also reviewed. The key bowel diseases that were studied were celiac disease, inflammatory bowel disease and irritable bowel syndrome. Interestingly, the incidence of irritable bowel syndrome was increased in patients with AA but there was no increase in inflammatory bowel disease and no increase in celiac disease.
Ying-Xiu Dai et al. 2022
In 2022, the authors set out to investigate the bidirectional relationship between AA and IBS. Participants were recruited from the National Health Insurance Research Database in Taiwan. The study participants included 5446 patients with AA and 21 784 matched controls to assess the risk of IBS, and 56 429 patients with IBS and 225 716 matched controls to assess the risk of AA.
What were the results?
After adjustment for potential confounders, patients with AA had an aHR of 5.20 [95% confidence interval (CI) 3.97-6.82] for IBS in comparison with the controls. Furthermore, compared with the controls, IBS patients had an aHR of 5.38 (95% CI 3.95-7.34) for AA.
Conclusion:
This study supports the notion that AA is bidirectionally associated with IBS. Further investigation is needed to elucidate the shared pathogenesis underlying these two diseases.
REFERENCE
Ying-Xiu Dai et al. Bidirectional association between alopecia areata and irritable bowel syndrome: A nationwide population-based cohort study. Australas J Dermatol . 2022 May;63(2):e127-e132. doi: 10.1111/ajd.13809. Epub 2022 Feb 23.
Conic R et al. Comorbidities in patients with alopecia areata. J Am Acad Dermatol . 2017 Apr;76(4):755-757. doi: 10.1016/j.jaad.2016.12.007.