Not only does smoking effect the course of the disease, it also effects the initial risk of suffering from the disease. Smokers are less likely to get ulcerative colitis, but interestingly former smokers have an increased risk of getting ulcerative colitis when compared to people who never smoked. Smokers were also less likely to have severe symptoms, and require surgery. On the other hand people who suffered from Crohn's disease and smoked were more likely to have a progressive form of the disease. I thought it was interesting that some Crohn's disease patients who quit smoking developed lesions that are typically seen in ulcerative colitis.
The conflicting effects made me wonder if it would be better to keep smoking if you had ulcerative colitis. It seems to be a good treatment, but you also have to consider the risks of smoking itself. Smoking can cause lung cancer, increases the risk of cardiovascular disease, and increases inflammation throughout the body. I thought maybe there was a way of isolating the beneficial effects of cigarettes without being exposed to the detrimental effects at the same time.
While reading the articles I assumed that the beneficial effects were due to the nicotine in the cigarettes and I wanted to know if using a nicotine patch was just as effective as cigarettes. I did some searching, and I found out there have been a few studies that used the transdermal nicotine patches to treat mild to moderate ulcerative colitis. The treatment was fairly successful, and when used with the conventional therapies it is even more successful.
So overall, it would be a good idea that anyone with IBD should quit smoking. Although it seems like smoking is a good way to treat ulcerative colitis, in the end it isn't worth the other risks smoking carries with it. Especially when nicotine patches are almost as effective as smoking itself.
7 comments:
I also thought that the effects of smoking on Inflammatory Bowel Disease was interesting. I must admit I was one of those people that confused IBD and IBS, too.
I am so shocked to see that some researchers of the past would group CD and UC together, especially with the effects of smoking being on complete opposite sides of the spectrum! Smoking is good for one, bad for the other; It's worse for women in one and worse for men in the other. It is definitely like comparing apples and oranges.
Another thing that made me think was chewing tobacco. Is the nicotine in chewing tobacco going to have the same effect as the nicotine in cigarettes or is it more than just the nicotine content?
A friend of mine was recently diagnosed with IBD. The interesting thing about her case was what got her to go to the doctor in the first place, the loss of her period (there were other symptoms, but that was the final straw). So, I started wondering what effects IBD had on women, pregnancy, and the fetus. It turns out that IBD can effect your monthly cycle, the time when it's best to get pregnanct without irritating the IBD symptoms and the fetus. It can even increase the chance of having miscarriages. I found some inteseting information on this site if anyone is interested.
http://www.4oman.gov/faq/ibd.htm#aa
I am curious, too, about the nicotine content between cigarettes, nicotine patches, and chewing tobacco. Although we briefly touched on the subject in class, would any physicians prescribe any of the tobacco products to anyone with UC if they did not already use tobacco products? I think its safe to say that almost every physician would advise to stop smoking, but would the use of the other two products be as detrimental or as helpful to UC?
I'm so excited to see comments about my post. I'll try to answer everyone's questions.
The amount of nicotine varies in cigarettes, chewing tobacco, transdermal patches, and nicotine gun.
Cigarettes: average is 1.9 mg
Chewing tobacco: average is 3.6 mg
Patches: 3 different doses 21, 14, 7 mg per day
Gum: 2-4 mg per piece
I couldn't find any studies that specifically studied the effects of chewing tobacco on IBD. But I did find some studies that studied nicotine patches, nicotine gum, and even a liquid enema that had nicotine in it. Overall the nicotine substitutes were fairly successful in treating ulcerative colitis, but there were some adverse effects. It was not as effective as smoking itself, but it did help. When the nicotine substitutes were combined with conventional treatments it was even more successful at treating ulcerative colitis.
This makes me think the various substances in cigarettes, like nicotine, carbon monoxide, and whether or not it's filtered, work together to help ulcerative colitis. So I don't know if chewing tobacco would be as effective as smoking itself, but it might have some beneficial effects. Researchers still aren't sure how cigarettes help ulcerative colitis, and there is a lot of conflicting studies. I think it would be interesting to see more studies about tobacco, nicotine and IBD.
I'm not sure if any physician would prescribe nicotine patches or gum as a way to treat ulcerative colitis. Some people experience adverse effects, and there is always a chance that a person might get addicted to the patch and gum. I think someone should really consider this a last option treatment. If conventional treatments have failed, someone might consider trying nicotine gum before opting for surgery. But I'm not a doctor, and I'm not a professional on this subject. I am in no way recommending this to someone without consulting a physician.
That was a great review of smoking and IBD. Recently there has been increasing interest in environmental risk factors for development of IBD. In addition to smoking having a difference researchers have found that presence of Helicobacter Pylori (bacteria found in GI tract)was reduced in Crohn's disease (CD), but not Ulcerative Colitis (UC). Other differences include a strong negative association with appendectomy in UC, but not in CD. Final 2 that I find very interesting is that CD has been associated with childhood eczema (evidence of atopy) and the frequent use of a swimming pool.
This raises the question of whether the "clean" life of the western populations where we are seeing huge increases in atopy is also placing children and young adults at increased risk for developing IBD.
2 interesting articles are:
Feeney MA, et al. A case-control study of childhood environmental risk factors for the development of inflammatory bowel disease. Eur J Gastroenterol Hepatol. 2002; 14(5): 529-534.
Timmer, A. Environmental influences on inflammatory bowel disease manifestations. Lessons in epidemiology. Dig Dis. 2003; 21 (2): 91-104
Post a Comment