Risk factors for extensive ulcerative colitis and ulcerative proctitis: a population based case-control study.

Samuelsson, Sven Mårten; Ekbom, Anders; Zack, M. M.; Helmick, Charles G.; Adami, H O

doi:10.1136/gut.32.12.1526

Cited by 52 publications

(34 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A meta-analysis of several large series of UC totalizing 1,489 patients [8,[25][26][27][28][29] gives an OR of 0.57 (95% CI 0.38-0.85) for total colectomy in current smokers when compared to non- smokers. In patients with distal UC at diagnosis, retrograde extension of the disease process is less frequent in smokers than in non-smokers [26,30,31] . Primary sclerosing cholangitis is observed almost exclusively in nonsmokers [32] .…”

Section: Impact Of Current Smoking On the Ibd Coursementioning

confidence: 99%

Smoking and Diet: Impact on Disease Course?

Cosnes¹

2016

Dig Dis

View full text Add to dashboard Cite

Background: The impact of current smoking on inflammatory bowel disease (IBD) course has been studied extensively; smoking is deleterious in Crohn's disease (CD), and beneficial in ulcerative colitis (UC). Except for enteral nutrition, there are only limited data regarding the impact of diet on disease course. Key Messages: Current smoking worsens the course of CD, increasing the incidence of flares, the need for steroids, immunosuppressants and re-operations. Conversely, smoking cessation has a rapid beneficial effect on disease course, decreasing the risk of flares and of post-operative recurrences. From 3 months after the quit date, quitters have a disease course similar to that of never smokers. Achieving smoking cessation in CD is thus an important goal of therapy. On the contrary, smoking improves the course of UC and in particular, is associated with a decreased need for colectomy. Smoking cessation increases the risk of flare and the need for steroids or immunosuppressants. However, patients with UC should not be discouraged to quit, because the beneficial effect of smoking for their disease is counterbalanced by the deleterious systemic effects of tobacco. Among dietary interventions, only exclusive enteral nutrition was shown to induce remission and achieve mucosal healing in some patients with CD. The beneficial effect of liquid-defined diet is observed whatever be the type of administration (orally or by tube), the type of diet regarding protein and fat content and resulting alterations in the gut microbiota. In UC, enteral nutrition has no effect. Finally, popularized restrictive diets in IBD as the specific-carbohydrate diet and the gluten-free diet have not been rigorously tested. In a small trial, a semi-vegetarian diet was shown to be effective in maintaining remission over 2 years in CD. Conclusions: Patients with IBD should not smoke and avoid passive smoking. Aside from the defined liquid diets, there is no rationale for advising particular diets.

show abstract

Section: Impact Of Current Smoking On the Ibd Coursementioning

confidence: 99%

Smoking and Diet: Impact on Disease Course?

Cosnes¹

2016

Dig Dis

View full text Add to dashboard Cite

show abstract

“…In concordance, a meta-analysis of several large series with a total of 1489 UC patients also found the risk for colectomy to be lower (OR: 0.57; 95% CI: 0.38-0.85) in current smokers compared with non-smokers [26] . In addition, in smokers with distal UC at diagnosis, the proximal extension of the disease is less frequent [22,27] , while primary sclerosing cholangitis is observed almost exclusively in non-smokers [28] . Disease regression [29] was also more likely to occur in smokers compared with nonsmokers or ex-smokers 5 years (30% vs 5% vs 8%), but not 10 years after the diagnosis.…”

Section: Effect Of Smoking and Its Cessation On Clinical Course And Ementioning

confidence: 99%

Smoking in inflammatory bowel diseases: Good, bad or ugly?

Lakatos¹

2007

WJG

View full text Add to dashboard Cite

Smoking is an important environmental factor in inflammatory bowel disease (IBD), having different effects in ulcerative colitis (UC) and Crohn's disease (CD). A recent meta-analysis partially confirmed previous findings that smoking was found to be p r o t e c t i v e a g a i n s t u l c e r a t i v e c o l i t i s a n d , a f t e r onset of the disease, might improve its course, d e c r e a s i n g t h e n e e d f o r c o l e c t o m y . H o w e v e r , smoking increases the risk of developing Crohn's disease and worsens its course, increasing the need for steroids, immunosuppressants and re-operations. Smoking cessation aggravates ulcerative colitis and improves Crohn's disease. Data are however, largely conflictive as well as the potential mechanisms involved in this dual relationship are still unknown. In this review article, the authors review the role of smoking in inflammatory bowel diseases.

show abstract

“…A meta-analysis of several large series of UC totaling 1,489 patients [17,25,35,[37][38][39] gives an odds ratio of 0.57 (95% CI 0.38-0.85) for total colectomy in current smokers when compared to non-smokers. In patients with distal UC at diagnosis, retrograde extension of the disease process is less frequent in smokers than in non-smokers [35,40,41] . Primary sclerosing cholangitis is observed almost exclusively in non-smokers [42] .…”

Section: Risk Of Developing Ucmentioning

confidence: 99%

Smoking, Physical Activity, Nutrition and Lifestyle: Environmental Factors and Their Impact on IBD

Cosnes

2010

Dig Dis

View full text Add to dashboard Cite

Current smoking increases the risk of developing Crohn’s disease and worsens its course, increasing the need for steroids, immunosuppressants, and re-operations. On the contrary, smoking protects against ulcerative colitis and after disease onset improves its course, decreasing the need for colectomy. Smoking cessation improves Crohn’s disease and worsens ulcerative colitis. Achieving smoking cessation in Crohn’s disease is thus an important goal of therapy, whereas patients with ulcerative colitis should not be discouraged to quit, because the beneficial effect of smoking for their disease is counterbalanced by the deleterious respiratory and cardiovascular effects of tobacco. Physical activity improves quality of life without detrimental effect on disease activity, and may contribute to increase muscle mass and to prevent osteoporosis. Regarding nutrition, a Western diet may be associated with an increased risk of IBD, and a case-control study revealed an increased consumption of linoleic acid before diagnosis of ulcerative colitis. Liquid diets may improve Crohn’s disease flares and decrease the need for steroids; however, there are no defined diets able to improve the disease course, and in Crohn’s disease, supplementation with omega-3 fatty acids did not show a significant benefit. Obesity is becoming more prevalent in IBD and may be associated with higher disease activity. In total, adhering to four simple lifestyle factors – never smoking, physical activity, prudent diet and body mass index <25 – may have a strong impact both on the prevention of major chronic diseases and on the course of IBD.

show abstract

Risk factors for extensive ulcerative colitis and ulcerative proctitis: a population based case-control study.

Cited by 52 publications

References 17 publications

Smoking and Diet: Impact on Disease Course?

Smoking and Diet: Impact on Disease Course?

Smoking in inflammatory bowel diseases: Good, bad or ugly?

Smoking, Physical Activity, Nutrition and Lifestyle: Environmental Factors and Their Impact on IBD

Contact Info

Product

Resources

About