Smoking may prevent pouchitis in patients with restorative proctocolectomy for ulcerative colitis.

Merrett, M N; Mortensen, N. J. McC.; Kettlewell, M. G. W.; Jewell, Derek

doi:10.1136/gut.38.3.362

Cited by 173 publications

(57 citation statements)

References 31 publications

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“…24 The literature remains divided, however, regarding smoking's effect on pouchitis following colectomy with ileal pouch-anal anastomosis. Although some cite a decreased rate of pouchitis among current smokers 5,42 others still observed no significant difference. 6,24,43 In fact, both van der Heide et al 24 and Joelsson et al 43 found a preponderance to pouchitis in current smokers compared to nonsmokers, but noted that the difference was not significant.…”

Section: 21mentioning

confidence: 92%

Review article: ulcerative colitis, smoking and nicotine therapy

Lunney

Leong

2012

Aliment Pharmacol Ther

121

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SummaryBackgroundSmoking is the best‐characterised environmental association of ulcerative colitis (UC). Smoking has been observed to exert protective effects on both the development and progression of UC.AimsTo examine the association between UC and smoking, possible pathogenic mechanisms and the potential of nicotine as a therapeutic agent in the treatment of UC.MethodsA literature search was conducted through MEDLINE, using the MeSH search terms ‘ulcerative colitis’ and ‘smoking’ or ‘nicotine’. Relevant articles were identified through manual review. The reference lists of these articles were reviewed to include further appropriate articles.ResultsUlcerative colitis is less prevalent in smokers. Current smokers with a prior diagnosis of UC are more likely to exhibit milder disease than ex‐smokers and nonsmokers. There is conflicting evidence for smokers having reduced rates of hospitalisation, colectomy and need for oral corticosteroids and immunosuppressants to manage their disease. Multiple potential active mediators in smoke may be responsible for these clinical effects, including nicotine and carbon monoxide, but the precise mechanism remains unknown. Nicotine has demonstrated variable efficacy in the induction of remission in UC when compared to placebo and conventional medicines. Despite this, the high frequency of adverse events limits its clinical significance.ConclusionsNicotine's application as a therapeutic treatment in ulcerative colitis is limited. Presently, it may be an option considered only in selected cases of acute ulcerative colitis refractory to conventional treatment options. This review also questions whether nicotine is the active component of smoking that modifies risk and inflammation in ulcerative colitis.

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Section: 21mentioning

confidence: 92%

Review article: ulcerative colitis, smoking and nicotine therapy

Lunney

Leong

2012

Aliment Pharmacol Ther

121

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“…Also, those with extensive disease were the lightest smokers, whereas those with healthy colons were the heaviest smokers. Finally, current smokers have a lower incidence of pouchitis following coloproctectomy with ileal reservoir when compared with non-smokers [30,31] . In contrast, intriguing new data by Aldhous et al [29] showed that current and non-smokers had an almost identical age at onset (31.1 vs 29.4 years) and this was delayed only in ex-smokers (46.5 years).…”

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

confidence: 99%

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

Lakatos¹,

Szamosi²,

Lakatos³

2007

WJG

134

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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.

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“…Etiological factors cited as possible associations include bacterial overgrowth, pouch mucosal ischemia, pouch fecal stasis and immune mediated inflammation. Merrett et al [75] reported the finding that smokers have significantly less episodes of pouchitis compared with nonsmokers. As well, Penna et al [76] noted a higher rate of pouchitis, 61 and 79% at 5 and 10 years post-IPAA, in patients with primary sclerosing cholangitis (PSC) compared with 36 and 45%, respectively, for non-PSC patients.…”

Section: Pouchitismentioning

confidence: 93%

Current Status of Surgery for Inflammatory Bowel Disease

Fazio¹

1998

Digestion

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Smoking may prevent pouchitis in patients with restorative proctocolectomy for ulcerative colitis.

Cited by 173 publications

References 31 publications

Review article: ulcerative colitis, smoking and nicotine therapy

Review article: ulcerative colitis, smoking and nicotine therapy

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

Current Status of Surgery for Inflammatory Bowel Disease

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