July 27,
2006
Smoking Does Not Decrease Pouchitis after
Surgery in Ulcerative Colitis
The latest issue of the Scandinavian Journal of Gastroenterology
reports that smoking does not decrease the risk of pouchitis
following ileal pouch anal anastomosis
for ulcerative colitis.
According to epidemiological
studies, a smoking habit is strongly associated with inflammatory bowel disease
(IBD) in that non-smokers, and especially recent
ex-smokers, have an increased risk of ulcerative colitis. Conversely,
concerning Crohn's disease, the risk is increased
among smokers. Pouchitis is the major long-term
complication of restorative proctocolectomy for
ulcerative colitis and seems to be pathogenetically
related to this condition. Swedish doctors tested the hypothesis that smoking
reduces the risk of pouchitis, investigating whether
cessation of smoking precedes the onset of the inflammation. The team included
410 living patients operated on for ulcerative colitis with proctocolectomy
and ileal pouch anal anastomosis
between 1982 and 1996. Data concerning smoking habits and pouchitis
were obtained from questionnaires and from medical records. The correlation
between smoking habits and incidence of pouchitis was
statistically evaluated by means of a survival test and a multivariate
analysis.
The team reported that 80 percent
completed the questionnaires. The researchers found that 29 percent of these
patients had had at least one episode of pouchitis
and that smoking habits during follow-up did not significantly influence the
risk of pouchitis. The team observed that neither
smoking habits before or at the time of ileal pouch
anal anastomosis correlated with the incidence of pouchitis and that women had a decreased risk of pouchitis, compared to men. The researchers identified a
non-significant tendency for smoking to increase the risk, which was more
pronounced in women. – Newsfeed from GastroHep.com
Scandinavian
Journal of Gastroenterology; 2006: 41(8): 929-33