Smoking and Inflammatory Bowel Disease: A Meta-analysis

Mahid, Suhal S.; Minor, Kyle S.; Soto, Roberto E.; Hornung, Carlton A.; Galandiuk, Susan

doi:10.4065/81.11.1462

Cited by 649 publications

(438 citation statements)

References 54 publications

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“…In a recent metaanalysis by Mahid et al [11] comparable values were reported, which also included new available data. Current smoking decreased the risk for UC (OR: 0.58; 95% CI: 0.45-0.75), while former smoking was associated with an increased risk (OR: 1.79; 95% CI: 1.37-2.34).…”

Section: Risk For Developing Ulcerative Colitismentioning

confidence: 49%

Smoking in inflammatory bowel diseases: Good, bad or ugly?

Lakatos¹

2007

WJG

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Smoking is an important environmental factor in inflammatory bowel disease (IBD), having different effects in ulcerative colitis (UC) and Crohn's disease (CD). A recent meta-analysis partially confirmed previous findings that smoking was found to be p r o t e c t i v e a g a i n s t u l c e r a t i v e c o l i t i s a n d , a f t e r onset of the disease, might improve its course, d e c r e a s i n g t h e n e e d f o r c o l e c t o m y . H o w e v e r , smoking increases the risk of developing Crohn's disease and worsens its course, increasing the need for steroids, immunosuppressants and re-operations. Smoking cessation aggravates ulcerative colitis and improves Crohn's disease. Data are however, largely conflictive as well as the potential mechanisms involved in this dual relationship are still unknown. In this review article, the authors review the role of smoking in inflammatory bowel diseases.

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Section: Risk For Developing Ulcerative Colitismentioning

confidence: 49%

Smoking in inflammatory bowel diseases: Good, bad or ugly?

Lakatos¹

2007

WJG

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“…In twin studies, Bridger found that in 23 dichotomous twin pairs, the smoker twin had CD in 91% of cases with an OR of 10.5 (95% CI, 2.6-92) and in another more recent study, the smoking twin from discordant pairs demonstrated an OR of 2.9 (95% CI, 1.2-7.1) ( 169 ). A meta-analysis by Mahid et al examined a total of nine studies reporting on smoking and development of CD ( 170 ). Th ey found a signifi cant association between current smoking and the development of CD with an OR of 1.76 (95% CI, 1.40-2.22) without signifi cant heterogeneity.…”

Section: Summary Of Evidencementioning

confidence: 99%

ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease

Farraye

Melmed

Lichtenstein

et al. 2017

American Journal of Gastroenterology

390

421

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Recent data suggest that infl ammatory bowel disease (IBD) patients do not receive preventive services at the same rate as general medical patients. Patients with IBD often consider their gastroenterologist to be the primary provider of care. To improve the care delivered to IBD patients, health maintenance issues need to be co-managed by both the gastroenterologist and primary care team. Gastroenterologists need to explicitly inform the primary care provider of the unique needs of the IBD patient, especially those on immunomodulators and biologics or being considered for such therapy. In particular, documentation of up to date vaccinations are crucial as IBD patients are often treated with long-term immune-suppressive therapies and may be at increased risk for infections, many of which are preventable with vaccinations. Health maintenance issues addressed in this guideline include identifi cation, safety and appropriate timing of vaccinations, screening for osteoporosis, cervical cancer, melanoma and non-melanoma skin cancer as well as identifi cation of depression and anxiety and smoking cessation. To accomplish these health maintenance goals, coordination between the primary care provider, gastroenterology team and other specialists is necessary. of evidence, we entered data from the papers of highest evidence into the GRADE program (accessible at http://www.gradepro.org ). Th e recommendation statements from this guideline are shown in Table 1 . Summary statements, when listed, are designed to be descriptive in nature without associated evidence-based ratings. VACCINATIONSRecent data suggest that IBD patients do not receive preventive services at the same rate as general medical patients ( 2 ). Members of the gastroenterology team are oft en the only clinicians that a patient with IBD will see. As such, it is incumbent upon gastroenterologists to take a proactive role in the health care needs of their IBD patients ( 3-5 ). It is crucial to clarify with the patient the limits of the specialist's responsibilities and delegate routine health care issues to the primary care clinician. It is equally important to educate the primary care clinician to the unique health maintenance needs of the IBD patient, especially those on immunomodulators and biologic agents. Although it appears that both primary care clinicians and gastroenterologists are hesitant to take ownership of vaccinations ( 6-8 ), it is reasonable ( 9 ) that vaccination recommendations be the responsibility of the treating gastroenterologist, but the actual delivery/administration of these vaccines may be a shared responsibility ( 10-13 ). Communicating specifi c recommendations to the primary care team in a concise fashion are needed. Consider empowering the patient by giving written recommendations to bring to their primary care physician. Clinicians sharing an electronic medical record should use this platform to send recommendations to the referring clinician.Patients with IBD are oft en treated with long-term immunesuppressive therapies and may t...

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“…12 NOS has been identified by the Cochrane Collaboration as 1 of the 2 most useful quality assessment tools for nonrandomized studies 13 and has been used frequently to assess the quality of nonrandomized studies. [14][15][16] The NOS uses a star rating system, with stars assigned for adhering to the following criteria.…”

Section: Quality Assessmentmentioning

confidence: 99%

Adolescent Health and Adult Education and Employment: A Systematic Review

2015

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OBJECTIVE: Poor health in adolescence has the potential to disrupt education and employment pathways. This study is the first systematic review of the literature examining education and employment outcomes in adulthood of poor adolescent mental and physical health. METHODS:We conducted searches using a standardized search protocol in 8 electronic databases: PsycINFO, Medline, Embase, ERIC, British Education Index, Australian Education Index, Social Sciences Citation Index, and CINAHL Plus. We identified studies that longitudinally compared adult education and employment outcomes of those with an adolescent chronic condition of clinical severity with healthy controls. We conducted metaanalyses using odds ratios (for dichotomous variables) and Cohen's d (for continuous variables) as our main summary statistics. RESULTS:We identified 27 studies incorporating 70 relevant analyses. Our meta-analyses suggested that overall, poor health in adolescence was associated with poorer education and employment outcomes in adulthood. However, evidence was much stronger for mental health conditions than for physical health conditions, for which less evidence was available and mixed findings emerged. Compared with mental health conditions, we identified few studies investigating the long-term outcomes of physical health conditions. Age and follow-up times varied considerably across our studies, which potentially resulted in some heterogeneity in effect sizes. The majority of included studies were conducted in the United States, raising questions about the generalizability of the results internationally.CONCLUSIONS: Health in adolescence contributes to adult attainment and life chances. The results suggest that investment in health may improve life chances and that policy interventions may improve outcomes for those with adolescent chronic conditions.

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Smoking and Inflammatory Bowel Disease: A Meta-analysis

Cited by 649 publications

References 54 publications

Smoking in inflammatory bowel diseases: Good, bad or ugly?

Smoking in inflammatory bowel diseases: Good, bad or ugly?

ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease

Adolescent Health and Adult Education and Employment: A Systematic Review

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