TONSILLECTOMY AND INFLAMMATORY BOWEL-DISEASE LOCATION

Objective: Epidemiological studies have found an increased frequency o f childhood infections and tonsillectomies in patients with inflammato ry bowel disease (IBD). The aim of our study was to test whether parti cular clinical patterns of IBD could be associated with previous tonsi llectomy. Methods: Two hundred and twenty consecutive IBD patients (10 0 with Crohn's disease (CD) and 120 with ulcerative colitis (UC)) were prospectively assessed and classified into groups according to diseas e location. In those with a positive history of tonsillectomy, an ear, nose and throat (ENT) examination was carried out to confirm the diag nosis. Results: Eighty-two IBD patients (37%) underwent tonsillectomy in childhood: 47 out of 100 CD patients (47%), and 35 out of 120 UC pa tients (29%). Disease location in CD patients affected the ileum in 28 , and 21 of them were tonsillectomized (tonsillectomy rate of 75%). Th irty-six patients had an ileocolonic location, and 14 of them had had a tonsillectomy (39%). With disease confined to the colon, only 9 out of 29 patients (31%) had undergone previous tonsillectomy. The higher prevalence of tonsillectomy in patients with CD ileitis was statistica lly significant (P = 0.0034). No significant differences between group s of UC patients according to the extent of the disease were found. Co nclusion: The ileum is the most prevalent location of disease in CD pa tients with previous tonsillectomy.