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Risk of inflammatory bowel disease in patients with rosacea: Results from a nationwide cohort study in Taiwan.

J Am Acad Dermatol. 2017 Jan 07;:

Authors: Wu CY, Chang YT, Juan CK, Shieh JJ, Lin YP, Liu HN, Lin JT, Chen YJ

Abstract
BACKGROUND: A link between rosacea and inflammatory bowel disease (IBD) has been proposed with unknown mechanisms. Epidemiologic evidence of this association needs to be examined.
METHODS: In this nationwide cohort study, a total of 89,356 patients with rosacea and 178,712 matched patients without rosacea between 1997 and 2013 were identified in the Taiwanese National Health Insurance Research Database. Cumulative incidences of IBD were compared between these 2 cohorts. Frailty Cox proportional hazard model was used and subgroup analyses were conducted to examine the risk factors for IBD.
RESULTS: The 15-year cumulative incidences of IBD were 0.036% (95% confidence interval [CI] 0.00%-1.57%) and 0.019% (95% CI 0.00%-0.83%) in rosacea and nonrosacea cohorts, respectively (P = .05). Rosacea (adjusted hazard ratio 1.94, 95% CI 1.04-3.63, P = .04) and male gender (adjusted hazard ratio 3.52, 95% CI 2.03-6.11, P < .01) were independently associated with IBD, after adjustment for major comorbidities. Multivariate subgroup analyses revealed consistent results. The incidence rates of IBD decreased with increasing antibiotic use in patients with rosacea, but without statistical significance.
LIMITATION: Information related to lifestyle, diet, alcohol, and smoking was not included in the database.
CONCLUSION: Patients with rosacea may have an increased risk of IBD.

PMID: 28073582 [PubMed - as supplied by publisher]

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"Among rosacea-associated gastrointestinal diseases, the evidence for inflammatory bowel disease is the strongest."
Adv Ther. 2021; 38(3): 1415–1424.
Rosacea, Germs, and Bowels: A Review on Gastrointestinal Comorbidities and Gut–Skin Axis of Rosacea
Fang-Ying Wang, Ching-Chi Chi

Etcetera
GUT Rosacea
Do You Have A Gut Feeling About Your Rosacea?

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"The association between inflammatory bowel disease (IBD) and rosacea is another topic of interest. A Taiwanese nationwide cohort study of over 89,000 patients with rosacea found an independent association with IBD incidence, as compared to matched controls. This association has been replicated by Egeberg et al.’s Danish study and Li et al.’s prospective study in American women. Moreover, both IBD and rosacea share possible genetic overlap on the histocompatibility complex class II gene HLA DRB1*03:01."

Diet and rosacea: the role of dietary change in the management of rosacea.

"In conclusion, our study demonstrates a modest association of rosacea with prevalent and incident IBD. Conversely, another study has shown that IBD is associated with an increase in rosacea.[68] Putting together the evidence, rosacea and IBD are related to each other. When rosacea patients suffer from chronic abdominal pain, prolonged diarrhea, and bloody stool, the possibility of comorbid IBD should be considered." 

Medicine: October 2019 - Volume 98 - Issue 41 - p e16448
Association of rosacea with inflammatory bowel disease
A MOOSE-compliant meta-analysis
Wang, Fang-Ying MD, Chi, Ching-Chi MMS, DPhil