Egeberg A, Weinstock L, Thyssen E, Gislason G, Thyssen J

BACKGROUND Rosacea is a common inflammatory facial skin condition. Recent genetic and epidemiologic studies have suggested pathogenic links between rosacea and gastrointestinal disorders, but data are limited.

OBJECTIVES The objective was to investigate the association between rosacea and celiac disease (CeD), Crohn's disease (CD), ulcerative colitis (UC), Helicobactor pylori (HP) infection, small intestinal bacterial overgrowth (SIBO), and irritable bowel syndrome (IBS), respectively.

METHODS We performed a nationwide cohort study. A total of 49,475 patients with rosacea, and 4,312,213 general population controls were identified using nationwide administrative registers. We established the prevalence of the aforementioned disorders, and used Cox regression to obtain hazard ratios (HRs) of the risk of new-onset CeD, CD, UC, HP infection, SIBO, and IBS, respectively, in patients with rosacea.

RESULTS The prevalence of CeD, CD, UC, HP infection, SIBO, and IBS, respectively, was higher among patients with rosacea when compared to the control subjects. Adjusted HRs revealed significant associations between rosacea and CeD (HR 1.46, 1.11-1.93), CD (HR 1.45, 1.19-1.77), UC (HR 1.19, 1.02-1.39), and IBS (HR 1.34, 1.19-1.50) respectively, but not HP infection (HR 1.04, 0.96-1.13) or SIBO (HR 0.71, 0.18-1.86).

CONCLUSIONS Rosacea is associated with certain gastrointestinal diseases, but the possible pathogenic link is unknown. Gastrointestinal complaints in patients with rosacea should warrant clinical suspicion of disease. 

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