Smoking and Risk of Microscopic Colitis: A Systematic Review and Meta-analysis

Jaruvongvanich, Veeravich; Poonsombudlert, Kittika; Ungprasert, Patompong

doi:10.1093/ibd/izy296

Cited by 48 publications

(37 citation statements)

References 33 publications

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“… 43 , 73–82 In a recent meta‐analysis, 83 current smokers had a significantly increased risk of MC compared with never smokers (odds ratio [OR]: 2.99, 95% CI: 2.15–4.15) 83 . Current smoking was more strongly associated with CC than LC (OR: 5.5, 95% CI: 3.4–8.9, OR: 2.96, 95% CI: 2.0–4.3, respectively) 83 . Former smoking was also associated with an increased risk (OR: 1.6, 95% CI: 1.4–1.9) 83 .…”

Section: Methodsologymentioning

confidence: 99%

“…83 Former smoking was also associated with an increased risk (OR: 1.6, 95% CI: 1.4-1.9). 83 was often assessed by self-administered questionnaires or review of medical records, and a homogeneous definition of smoking was lacking.…”

Section: Summary Of Evidencementioning

confidence: 96%

“…83 Former smoking was also associated with an increased risk (OR 1.6, 95% CI: 1.4-1.9). 83 However, inter-study heterogeneity was high or moderate for all analyses. Smoking status was We recommend against use of probiotics for treatment of MC.…”

Section: Epidemiology and Risk Factors Of MC What Is The Incidence Omentioning

confidence: 96%

“…LE: moderate; GR: NA; agreement: 100%, strong consensus Summary of evidence: the prevalence of current smoking in MC patients ranged from 15.3% to 40.7% (CC: 13.6-37.1%; LC: 13.2-26.0%) compared to 5.0-28.2% in non-MC control groups. 28,43,[73][74][75][76][77][78][79][80][81][82] In a recent meta-analysis, 83 current smokers had a significantly increased risk of MC compared with never smokers (odds ratio (OR) 2.99; 95% CI: 2.15-4.15). 83 Current smoking was more strongly associated with CC than LC (OR 5.5, 95% CI: 3.4-8.9; OR 2.96, 95% CI: 2.0-4.3, respectively).…”

Section: Epidemiology and Risk Factors Of MC What Is The Incidence Omentioning

confidence: 99%

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European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations

et al. 2021

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Introduction Microscopic colitis is a chronic inflammatory bowel disease characterised by normal or almost normal endoscopic appearance of the colon, chronic watery, non-bloody diarrhoea and distinct histological abnormalities, which identify three histological subtypes, the collagenous colitis, the lymphocytic colitis and the incomplete microscopic colitis. With ongoing uncertainties and new developments in the clinical management of microscopic colitis, there is a need for evidence-based guidelines to improve the medical care of patients suffering from this disorder. Methods Guidelines were developed by members from the European Microscopic Colitis Group and United European Gastroenterology in accordance with the Appraisal of Guidelines for Research and Evaluation II instrument. Following a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation methodology was used to assess the certainty of the evidence. Statements and recommendations were developed by working groups consisting of gastroenterologists, pathologists and basic scientists, and voted upon using the Delphi method. Results These guidelines provide information on epidemiology and risk factors of microscopic colitis, as well as evidence-based statements and recommendations on diagnostic criteria and treatment options, including oral budesonide, bile acid binders, immunomodulators and biologics. Recommendations on the clinical management of microscopic colitis are provided based on evidence, expert opinion and best clinical practice. Conclusion These guidelines may support clinicians worldwide to improve the clinical management of patients with microscopic colitis.

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Section: Methodsologymentioning

confidence: 99%

Section: Summary Of Evidencementioning

confidence: 96%

Section: Epidemiology and Risk Factors Of MC What Is The Incidence Omentioning

confidence: 96%

Section: Epidemiology and Risk Factors Of MC What Is The Incidence Omentioning

confidence: 99%

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European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations

et al. 2021

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“…The patient was initially treated with oral budesonide 9 mg/day, with gradually decreasing diarrhea, but mesalamine 800 mg twice daily was added as therapy because of persisting non-bloody diarrhea, with subsequent improvement. The patient was advised to cease smoking, as recommended for patients with collagenous colitis [23], but refused.…”

Section: Case Reportmentioning

confidence: 99%

Novel Case Report: A Previously Reported, but Pathophysiologically Unexplained, Association Between Collagenous Colitis and Protein-Losing Enteropathy May Be Explained by an Undetected Link with Collagenous Duodenitis

et al. 2021

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Collagenous colitis (CC) is associated with non-bloody, watery diarrhea, which is pathophysiologically reasonable because normal colonic absorption (or excretion) of water and electrolytes can be blocked by the abnormally thick collagen layer in CC. However, CC has also been associated with six previous cases of protein-losing enteropathy (PLE), with no pathophysiologic explanation. The colon does not normally absorb (or excrete) amino acids/proteins, which is primarily the function of the small bowel. Collagenous duodenitis (CD) has not been associated with PLE. This work reports a novel case of CD (and CC) associated with PLE; a pathophysiologically reasonable mechanism for CD causing PLE (by the thick collagen layer of CD blocking normal intestinal amino acid absorption); and a novel association of PLE with severe COVID-19 infection (attributed to relative immunosuppression from hypoproteinemia, hypoalbuminemia, hypogammaglobulinemia, and malnutrition from PLE).

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Celiac disease and risk of microscopic colitis: A nationwide population‐based matched cohort study

et al. 2023

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Background: An association has been reported between celiac disease (CD) and microscopic colitis (MC). However, large, population-based cohort studies are rare.Objective: To systematically examine the association between CD and MC in a large, nationwide cohort. Methods: We conducted a nationwide population-based matched cohort study in Sweden of 45,138 patients with biopsy-verified CD (diagnosed in 1990-2016), 223,149 reference individuals, and 51,449 siblings of CD patients. Data on CD and MC were obtained from all (n = 28) pathology departments in Sweden. Adjusted hazard ratios (aHRs) were calculated using Cox regression. Results: During follow-up, 452 CD patients and 197 reference individuals received an MC diagnosis (86.1 vs. 7.5 per 100,000 person-years). This difference corresponded to an aHR of 11.6 (95% confidence interval [CI] = 9.8-13.8) or eight extraMC cases in 1000 CD patients followed up for 10 years. Although the risk of MC was highest during the first year of follow-up (aHR 35.2; 95% CI = 20.1-61.6), it remained elevated even after 10 years (aHR 8.1; 95% CI = 6.0-10.9). Examining MC subtypes lymphocytic colitis (LC) and collagenous colitis (CC) separately, the aHR was 12.4 (95% CI = 10.0-15.3) for LC and 10.2 (95% CI = 7.7-13.6) for CC. MC was also more common before CD (adjusted odds ratio [aOR] = 52.7; 95% CI = 31.4-88.4). Compared to siblings, risk estimates decreased but remained elevated (CD and later MC: HR = 6.2; CD and earlier MC: aOR = 7.9). Conclusion:Our study demonstrated a very strong association of MC with CD with an increased risk of future and previous MC in CD patients. The magnitude of the associations underscores the need to consider the concomitance of these diagnoses in cases in which gastrointestinal symptoms persist or recur despite a gluten-free diet or conventional MC treatment. The comparatively lower risk estimates in sibling comparisons suggest that shared genetic and early environmental factors may contribute to the association between CD and MC.

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Smoking and Risk of Microscopic Colitis: A Systematic Review and Meta-analysis

Cited by 48 publications

References 33 publications

European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations

European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations

Novel Case Report: A Previously Reported, but Pathophysiologically Unexplained, Association Between Collagenous Colitis and Protein-Losing Enteropathy May Be Explained by an Undetected Link with Collagenous Duodenitis

Celiac disease and risk of microscopic colitis: A nationwide population‐based matched cohort study

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