Concurrence of inflammatory bowel disease and multiple sclerosis

Objectives: To quantify the coexistence of inflammatory bowel disease (IBD) and multiple sclerosis (MS) and to characterize the diseases when they coe xist, Patients and Methods: In this retrospective study of medical records spanni ng 1950 through 1995, the diagnoses of Crohn disease (CD), ulcerative colit is (UC), and MS were based on review of inpatient and outpatient records by a gastroenterologist and a neurologist, Results: We identified 4 residents of Olmsted County, Minnesota, with IBD ( 3 UC, I CD) who had concurrent, clinically definite MS; all had mild neurol ogic disease with little disability. These comprised 1% of the IBD and 1.8% of the MS cohort, The CD patient had undergone terminal ileal resection; o f the UC patients, 2 had pancolitis, and I had proctosigmoiditis. The obser ved prevalence of MS at onset of IBD was 3.7 times the expected (95% confid ence interval, 0.8-10.8), We also reviewed the records of 32 referral patie nts with both diagnoses. Disability from MS was moderate at median follow-u p of 8.5 Sears. By 15 years, ambulation was impaired in most patients. Neur ologic disability was similar between patients with CD and UC, Conclusions: Concurrence of the 2 diseases was greater than expected. Altho ugh MS and IBD may share common predisposing factors, not enough informatio n is available to speculate about possible mechanisms.