Does Cigarette Smoking Influence the Phenotype of Crohn's Disease? Analysis Using the Montreal Classification

Aldhous, Marian C.; Drummond, Hazel E.; Anderson, Niall; Smith, Linda A.; Arnott, Ian; Satsangi, Jack

doi:10.1111/j.1572-0241.2007.01064.x

Cited by 98 publications

(68 citation statements)

References 41 publications

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“…The difference in age at diagnosis between smokers and those who had never smoked was as much as 14 years. This difference has not been observed in CD patients where the age at onset was similar for smokers and nonsmokers (28.3 years and 28.9 years) [28].…”

Section: Discussionmentioning

confidence: 70%

Is smoking a risk factor for collagenous colitis?

Vigren

Sjöberg

Benoni

et al. 2011

Scandinavian Journal of Gastroenterology

108

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Objective. The association between smoking and idiopathic inflammatory bowel disease is well known; smoking seems to have a diverse effect. Crohn´s disease is associated with smoking, while ulcerative colitis is associated with non-smoking. Data on smoking in microscopic colitis of the collagenous type (CC) is lacking. The aim of this investigation was to study smoking habits in collagenous colitis and to observe whether smoking had any impact on the course of the disease. Materials and Methods.116 patients (92 women) with median age of 62 years (IQR 55-73) answered questionnaires covering demographic data, smoking habits and disease activity. As control group we used data from the general population in Sweden retrieved from the National Statistics Office of Sweden, the central bureau for national socioeconomic information. Results. Of the 116 CC patients, 37% were smokers compared to 17 % of controls (p<0.001, OR 2.95). In the age group 16-44 years, 75 % of CC patients were smokers compared to 15 % of controls (p<0.001, OR 16.54). All CC smoker patients started smoking before the onset of disease. Furthermore, smokers developed the disease earlier than non-smokers -at 42 years of age (median) compared with 56 years in non-smokers (p<0.003). Although the proportion with active disease did not differ between smokers and non-smokers, there was a trend indicating that more smokers received active treatment (42% vs. 17%), p=0.078). Conclusions. Smoking is a risk factor for collagenous colitis. Smokers develop their disease more than ten years earlier than non-smokers.

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Section: Discussionmentioning

confidence: 70%

Is smoking a risk factor for collagenous colitis?

Vigren

Sjöberg

Benoni

et al. 2011

Scandinavian Journal of Gastroenterology

108

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“…13 For instance, aside from differences in clinical and demographic characteristics, and risk factors such as smoking (which shows a higher prevalence rate in patients with ileal disease), others have noted various other differences in pathology, such as a lower (or higher) incidence of perianal disease, and a lower incidence of stenosis and penetrating/fistulating disease, in patients with isolated colonic Crohn's disease. 13,26,[28][29][30][31][32] Aside from the HLA DRB1*0103 results noted by Hancock et al, 26 other Crohn's disease susceptibility loci, such as NOD 2, inflammatory bowel disease 5, NOD 1, Isle 23R, and ATC16L1 have also been shown to be associated with Crohn's disease. 13,[33][34][35][36][37] Unfortunately, none of these molecular studies correlated the presence of polymorphisms, or mutations, with specific pathological subtypes of Crohn's disease.…”

Section: Discussionmentioning

confidence: 99%

Clinical and pathological analysis of colonic Crohn's disease, including a subgroup with ulcerative colitis-like features

et al. 2012

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“…For UC, increasing tobacco load has been associated with less severe disease ( 9 ). For CD, an increasing load was not associated with disease severity, however, it was associated with location of disease ( 10 ). Current smokers had more terminal ileal or ileocolonic disease and less colonic disease than nonsmokers.…”

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confidence: 91%

Editorial: The Truth About Cigarette Smoking and the Risk of Inflammatory Bowel Disease

Rosenfeld

Bressler

2012

American Journal of Gastroenterology

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The etiology of infl ammatory bowel disease (IBD) is generally believed to be multifactorial in nature involving both genetic and environmental factors. Cigarette smoking has been shown through previous retrospective observational studies to be an environmental factor with both positive and negative infl uences in IBD. Smoking increases the risk of developing Crohn ' s disease (CD) but not the risk of ulcerative colitis (UC). Meanwhile smoking cessation increases the risk of a UC fl are while CD patients are more likely to show a decrease in disease severity. Unfortunately, these observational studies cannot control for bias the way a randomized controlled trial can, however, they still reveal meaningful truths about smoking and IBD. The study by Higuchi et al. ( 1 ) adds to our understanding of the impact of smoking on IBD in several ways. They showed that increasing exposure to smoking is associated with an increased risk of developing CD. They also showed that the risk of UC is highest in the fi rst 2 -5 years after smoking cessation but remains elevated for > 20 years. This research also raises several new issues regarding the association between smoking and IBD, which hopefully will be answered through future well-designed observational studies.

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Does Cigarette Smoking Influence the Phenotype of Crohn's Disease? Analysis Using the Montreal Classification

Abstract: Smoking habit was associated with age at diagnosis and disease location in Crohn's disease, while disease location was associated with the rate of development of stricturing complications and requirement for surgery. The pathogenic basis of these observations needs to be explained.

Cited by 98 publications

References 41 publications

Is smoking a risk factor for collagenous colitis?

Is smoking a risk factor for collagenous colitis?

Clinical and pathological analysis of colonic Crohn's disease, including a subgroup with ulcerative colitis-like features

Editorial: The Truth About Cigarette Smoking and the Risk of Inflammatory Bowel Disease

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