Cigarette Smoking and Appendectomy are Risk Factors for Extraintestinal Manifestations in Ulcerative Colitis

Abstract

In UC patients, appendectomy and cigarette smoking are prognostic factors for the development of EIM. The unfavorable effect of cigarette smoking on EIM is additive to that of appendectomy.

Does nicotine influence cytokine profile and subsequent cell cycling/apoptotic responses in inflammatory bowel disease?

“…68 Extraintestinal manifestations occur in both UC and CD 69 indicating that systemic immunity is affected in IBD. In UC, extra-intestinal manifestations may be associated with smoking, 70 but the cytokine and cell cycle models were not affected by smoking habit.…”

Smoking complicates the course of non-infectious uveitis

“…Present knowledge concerning the impact of smoking on course or incidence of diseases comprises both negative and positive effects. Among the autoimmune diseases, smoking was proven to be associated with an increased risk of Crohn's disease, greater severity of fibromyalgia, and higher risk for extraintestinal manifestations in ulcerative colitis [1][2][3]. Many studies have also focused on the correlation between smoking and rheumatoid arthritis (RA); here, smoking was identified as an important risk factor for the development and severity of RA, particularly in heavy smokers [4][5][6][7][8][9].…”

Review article: ulcerative colitis, smoking and nicotine therapy

“…One study found that current cigarette smoking in UC patients increased the risk of articular and dermatological EIMs, whereas no such increase was observed in ocular or hepatobiliary complications. 38 Current or previous smoking has also been shown to reduce instances of primary sclerosing cholangitis 1,5,6,24,[39][40][41] and backwash ileitis. 24 The literature remains divided, however, regarding smoking's effect on pouchitis following colectomy with ileal pouch-anal anastomosis.…”