smoking in UC

 Q: 37 years old male is admitted to ICU with lower gastrointestinal (GI) bleed. Workup led to diagnosis of ulcerative colitis (UC). Patient recently quit his smoking habit. UC is relatively hard to treat in this patient.

A) True

B) False

Answer: A

Cigarette smoking has a protective tendency in UC. Interestingly, patients who develop UC after quitting tobacco are relatively hard to treat. On the same token, disease severity may improve at the resumption of cigarette smoking. 

In contrast, smoking increases the risk of Crohn's disease (CD) and may make CD symptoms worse.

#GI

References:

1. To N, Ford AC, Gracie DJ. Systematic review with meta-analysis: the effect of tobacco smoking on the natural history of ulcerative colitis. Aliment Pharmacol Ther 2016; 44:117.

2. Beaugerie L, Massot N, Carbonnel F, et al. Impact of cessation of smoking on the course of ulcerative colitis. Am J Gastroenterol 2001; 96:2113.

3.  Ryan WR, Allan RN, Yamamoto T, Keighley MR. Crohn's disease patients who quit smoking have a reduced risk of reoperation for recurrence. Am J Surg 2004; 187:219.

4. Boyko EJ, Perera DR, Koepsell TD, et al. Effects of cigarette smoking on the clinical course of ulcerative colitis. Scand J Gastroenterol 1988; 23:1147.

5. Beaugerie L, Massot N, Carbonnel F, et al. Impact of cessation of smoking on the course of ulcerative colitis. Am J Gastroenterol 2001; 96:2113.