Crohn's Disease, Bronchiectasis, and Biologics

Posted by bronchiectasaurus @bronchiectasaurus, 18 hours ago

Anyone else here have Crohn's? What is known about the connection between Crohn's and Bronchiectasis? Some think it's an extra-intestinal manifestation of Crohn's in some patients; anyone know of sources for that? Are Biologics used to treat Bronchiectasis itself, or do they make it worse by lowering immunity?

I was diagnosed with Crohn's Disease late 2023, 8 months after a brutal and extended case of Covid. My guts were fine before Covid, as were my lungs. I am now stable on Skyrizi, a monoclonal antibody/biologic injection every 8 weeks.
Early March of this year, despite hermit-like precautions, I got some nasty virus and just didn't recover. Then I got something else on top of it, with nosebleeds and conjuctivitis and a cough that just wouldn't quit. After 2 months of this I got a CT scan which showed bronchiectasis, among other things. Have been nebbing hypertonic saline 2x daily since then, 2x daily nasal lavage, and feeling much better. I'm still establishing my routine for daily lung care.

Having to be on an immosuppressant (Skyrizi) through all this is no fun. I now mask everywhere. I was already something of a hermit; I will continue, intentionally. No longer will I think of keeping my immune system "in shape" via exposure to everyday pathogens. I consider my immune system hopelessly broken. However bad bronchiectasis is -- and it's bad -- Crohn's is also a nightmare, and I do not want those symptoms to return, even if it means masking, isolating, and devoting much time every day to salting my airways.

Just wondering if anyone else here is in the same boat, and how you navigate these waters.

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

scoop | @scoop | 16 hours ago

Welcome to the group. I am sorry you have to be here! I hope you'll find a lot of support and information. There's a search feature in the forum, which I entered the word "Crohn's" and came up with a list of discussions where it is mentioned. I believe within the discussions you can drill down and run another search. I hope you will hear from others with Crohn's.
https://connect.mayoclinic.org/group/mac-bronchiectasis/?search=crohn%27s#discussion-listview
Recently, I learned that 40% of the causes of bronchiectasis are unknown, aka idiopathic. Perhaps this explains why we are all seem so different -- varying degrees of symptoms, cough, sputum production, bacteria we grow and harbor, etc. Yet, airway clearance for all is the cornerstone of managing the disease. It's great that you are on board with airway clearance. The single most important thing we can be doing for ourselves.

Here is a chart from a few years I copied from the NEJM about the various causes of the bronchiectasis.

Shared files

Causes of Disease in the Diagnosis of Bronchiectasis (Causes-of-Disease-in-the-Diagnosis-of-Bronchiectasis-.pdf)