Chronic cough in a patient with stable ulcerative colitis: a rare but important extraintestinal manifestation of inflammatory bowel disease

A 74-year-old woman presented to her general practitioner with cough and occasional sputum production. Having failed to respond to courses of antibiotics in the community, she was referred to the thoracic medicine clinic. High-resolution CT chest revealed cylindrical bronchiectasis predominantly in the right lower lobe. Lung function revealed preserved FEV1 and FVC but reduced gas transfer values. Bronchiectasis secondary to ulcerative colitis was diagnosed. Inhaled corticosteroid therapy was initiated, with good clinical response noted at 6 monthly follow-up. Remission was sustained with tapering of the steroid dose. Recognition of respiratory complications in cases of inflammatory bowel disease is likely still poor among clinicians. Although rare, a working knowledge of principles of investigation and management will aid timely diagnosis and treatment, potentially preventing progression of respiratory disease.