Impact of Smoking on Anal Abscess and Anal Fistula Diseases

Zheng, Lihua; Zhang, Aozhe; Shi, Yuying; Li, Xin; Jia, Lansi; Zhi, Congcong; Yu, Qiuxiang; Zhang, Wen; Liu, Yanjun; Wang, Luan; Xiao, Dan; Wang, Chen

doi:10.4103/0366-6999.230738

Cited by 15 publications

(10 citation statements)

References 19 publications

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“…Also, a prospective study that assessed the long-term recurrence rate after anal surgery found that all fistulas occurred before 24 months [ 14 ]. In our study, smoking was not associated with greater risk of anal fistula, in contrast with published epidemiological data [ 10 , 11 , 15 ]. We cannot exclude a lack of statistical power since univariate analysis showed a significant association but multivariate analysis did not.…”

Section: Discussioncontrasting

confidence: 99%

Increased Long-term Risk of Anal Fistula After Proctologic Surgery: A Case-Control Study

Assaraf

Lambrescak

Lefèvre³

et al. 2021

Ann Coloproctol

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Purpose: Anal fistula is a common condition in proctology, usually requiring surgical treatment. Few risk factors have been clearly identified based on solid evidence. Our research objective was to determine whether history of anal surgery was a risk factor for subsequent anal fistula.Methods: We conducted a case-control study from January 1, 2012 through December 31, 2013 in our tertiary center, comprising 280 cases that underwent surgery for anal fistula and 123 control patients seeking a consultation for upper gastrointestinal symptoms. Patients with inflammatory bowel disease were excluded. For both cases and controls, the following variables were recorded: sex, any prior anal surgery, diabetes mellitus, infection with human immunodeficiency virus, and smoking status. For each variable, confidence interval and odds ratio (OR) were calculated.Results: In univariate analysis, male sex (73.2% vs. 31.7%, P < 0.0001), active smoking (38.1% vs. 22%, P = 0.0015), and prior anal surgery (16.0% vs. 4.1%, P = 0.0008) were associated with higher risk of anal fistula. In multivariate analysis, only male sex (OR, 5.5; 95% confidence interval [CI], 5.42 to 9.10; P < 0.0001) and previous anal surgery (OR, 4.48; 95% CI, 1.79 to 13.7; P = 0.0008) remained independently associated with anal fistula occurrence.Conclusion: The epidemiology of anal fistula is poorly assessed despite the high frequency at which it is diagnosed. Our findings suggest that history of any kind of anal surgery is a risk factor for further onset of anal fistula. Surgeons and patients must be informed of this issue.

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Section: Discussioncontrasting

confidence: 99%

Increased Long-term Risk of Anal Fistula After Proctologic Surgery: A Case-Control Study

Assaraf

Lambrescak

Lefèvre³

et al. 2021

Ann Coloproctol

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“…Since the location of disease is a powerful indicator of behavior change, it could have suppressed the effect of smoking status due to a multicollinearity effect in the regression model. This might have led to a type II error regarding the influence of smoking on behavior change in the study by Aldhous et al [21] Also Zheng et al [22] reported that; smoking to be a potential risk factor for the development of anal abscess and anal fistula diseases in population without inflammatory bowel disease. In our study, location of disease was evenly distributed among patients with different smoking habits, and current smoking was found to be independently associated with intestinal complications.…”

Section: Discussionmentioning

confidence: 99%

Risk factors associated with progression to intestinal complications of Crohn disease

Kayar¹,

Baran

Örmeci

et al. 2019

Chinese Medical Journal

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Background:Crohn disease is a chronic bowel disease that causes serious complications. Prevalence of Crohn disease is increasing. Studies have shown that the behavior of the disease is not stable and severe complications secondary to behavior change over time have been shown. In this study, we aimed to evaluate the prognostic risk factors associated with phenotypic change in Crohn disease in a Turkish patient cohort.Methods:Patients followed up from March 1986 to August 2011 were evaluated for demographic and clinical characteristics to determine possible risk factors and initial clinical phenotype of the disease based on the Montreal classification. The cumulative probabilities of developing stricturing or penetrating intestinal complications were estimated using the Kaplan-Meier analysis. Univariate and multivariate Cox-proportional hazard models were used to assess associations between baseline clinical characteristics and intestinal complications.Results:Three hundred and thirty patients (mean age, 30.6 ± 11.1 years; 148 female) were included in the study. Mean follow-up duration was 7.4 ± 5.3 years (range: 1.0–25.0 years). At baseline 273 patients had inflammatory-type disease, 57 patients experienced stricturing/penetrating intestinal complications before or at the time of diagnosis. The cumulative probability of developing complicated disease was 37.4% at 5 years, 54.3% at 10 years, 78.8% at 25 years. Independent predictors associated with progression to intestinal complications were current smoking, perianal disease, extra-intestinal manifestations, and location of disease.Conclusions:Location of disease is the most powerful indicator for the development of stenosis and penetrating complications in inflammatory-type disease. Patients with ileal involvement should be considered for more aggressive immunosuppressive therapy.

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“…Studies have shown that smoking increases the risk of anal abscesses. Zheng et al 144 reported that smoking is associated with anal abscess and anal fistula disease (OR=12.331; 95% CI: 8.364-18.179). Devaraj et al 145 proved that the risk of anal abscess/anal fistula among military veterans with a smoking history within 1, 5 and 10 years was 2.15, 1.72, and 1.34 times that of non-smoking veterans, respectively.…”

Section: Smoking and Anal Abscessmentioning

confidence: 99%

Smoking increases the risk of infectious diseases: A narrative review

Chen¹,

Chen²,

Xie³

2020

Tob. Induc. Dis.

126

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Smoking is one of the most severe public health problems in the world. According to the WHO Global report on trends in prevalence of tobacco use 2000-2025, smoking accounts for 9% of all deaths worldwide, and more than half of smokers die from smoking-related diseases 1. China is the largest producer and consumer of tobacco in the world. In 2018, about 26.6% of adults (aged ≥15 years; 308 million in total) were current smokers and 44.9% of adults (515 million) were exposed to secondhand smoke at home 1. Exposure to cigarette smoke and secondhand smoke is very harmful to human health. There are over 7000 chemical components in tobacco smoke, of these, over 250 are toxic or carcinogenic, such as aldehydes, nitrides, and others that irritate the respiratory tract. Nicotine leads to tobacco addiction; benzpyrene, arsenic, cadmium and other components have carcinogenic effects and nitric oxide can reduce oxygen transport by erythrocytes. Smoking can damage nearly all organs of the human body and is one of the main risk factors for respiratory infection and infectious diseases in other systems, in a dose-dependent manner 2,3. In this review, we discuss the mechanisms and influence of smoking on infections in various systems, including the respiratory system, digestive system, and genital system, among others, in order to provide evidence for the active promotion of smoking cessation. DEVELOPMENTS Mechanisms of susceptibility The potential mechanisms of how cigarette smoke increases the risk of systemic infections are not completely understood. These may include alteration ABSTRACT Smoking is relevant to infectious diseases resulting in increased prevalence and mortality. In this article, we aim to provide an overview of the effects of smoking in various infections and to explain the potential mechanisms. We searched PubMed and other relevant databases for scientific studies that explored the relationship between smoking and infection. The mechanisms of susceptibility to infection in smokers may include alteration of the structural, functional and immunologic host defences. Smoking is one of the main risk factors for infections in the respiratory tract, digestive tract, reproductive tract, and other systems in humans, increasing the prevalence of HIV, tuberculosis, SARS-CoV, and the current SARS-CoV-2. Smoking cessation can reduce the risk of infection. Smoking increases the incidence of infections and aggravates the progress and prognosis of infectious diseases in a dose-dependent manner. Smoking cessation promotion and education are the most practical and economical preventive measures to reduce aggravation of disease infection owing to tobacco use.

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Impact of Smoking on Anal Abscess and Anal Fistula Diseases

Cited by 15 publications

References 19 publications

Increased Long-term Risk of Anal Fistula After Proctologic Surgery: A Case-Control Study

Increased Long-term Risk of Anal Fistula After Proctologic Surgery: A Case-Control Study

Risk factors associated with progression to intestinal complications of Crohn disease

Smoking increases the risk of infectious diseases: A narrative review

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