27 November 2010
Smoking and Crohn's Disease
Smoking and increased sugar intake have been found to be the only consistent environmental risk factors for Crohn's disease. There has been an association found between smoking and increased added sugar intake; 51% of people who have an increased sugar consumption in their diet reported being a smoker and in the group of people who reported no increased sugar added to their diet, 20% were smokers. This study used patients from a cohort that they had been following for 2-4 years, with no new patients diagnosed with Crohn's disease were used. This narrowed the ability to see the impact of those who start smoking after being diagnosed with Crohn's disease versus those who have already been smoking for a number of years and are newly diagnosed with Crohn's disease. In many Crohn's disease patients now, they have a knowledge of the link between Crohn's disease and smoking and increased sugar intake, so it is hard to run new studies on the link between Crohn's disease and smoking.
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I remember from on of the papers that we read that former smokers were at greater risk than lifelong non-smokers. However, sugar intake affected both with the former smokers being affected most. They were affected to the same or greater extent at current smokers. It as if one pathway runs parallel wit the other so it is hard to do studies that can clearly differentiate between the two risks. This is just from memory though.
ReplyDeleteA kind of counter point to the blog post is the relationship between smoking and ulcerative colitis, another irritable bowel disease. UC is largely associated with nonsmokers and people who have quit smoking. Colitis patients who quit smoking develop colitis a few years after quitting. Steroids and immunosuppressive agents are standard treatment of UC. While, it is not a good idea to recommend patients to pick up smoking, some groups have looked at the possibility of using nicotine patches to help induce remission with some promising results. It is interesting that these two IBDs have such opposite reactions to smoke exposure.
ReplyDeleteMcGrath J, McDonald JWD, MacDonald JK. Transdermal nicotine for induction of remission in ulcerative colitis. Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No.: CD004722. DOI: 10.1002/14651858.CD004722.pub2