This study aims to explore the mechanisms that connect chronic intestinal inflammation in IBD to vascular dysfunction and stroke, and to evaluate how IBD-related medications may influence stroke risk.
Inflammatory bowel disease (IBD), comprising Crohn’s disease and ulcerative colitis, is primarily recognized for gastrointestinal complications. However, emerging evidence suggests a link between IBD and an increased risk of cerebrovascular events, including stroke. Persistent inflammation in IBD may contribute to endothelial dysfunction, hypercoagulability, and accelerated atherosclerosis, raising stroke risk. This study reviews the mechanisms linking chronic intestinal inflammation to vascular dysfunction and stroke, and assesses the role of IBD-related medications in stroke risk.
A literature review was conducted using databases such as PubMed and Scopus. Population-based studies investigating IBD and stroke were selected. Pathophysiological mechanisms, including inflammation, pro-thrombotic states, and the effects of corticosteroids and biologic therapies, were analyzed, with a focus on inflammatory markers like TNF-α and IL-6.
Studies indicate that IBD patients, particularly younger individuals, have higher rates of ischemic and hemorrhagic strokes. Chronic inflammation, driven by elevated TNF-α and IL-6, promotes endothelial dysfunction and a pro-thrombotic environment. IBD therapies, especially corticosteroids, have been associated with increased stroke risk, while the effects of biologic agents are under investigation.
IBD is associated with a higher risk of cerebrovascular events, exacerbated by chronic inflammation and certain therapies. A multidisciplinary approach, involving gastroenterology and neurology, is crucial for managing stroke risk in IBD patients. Further research is needed to establish stroke prevention guidelines for this population.