According to epidemiological studies, smoking habit is strongly associated with inflammatory bowel disease (IBD).
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.
Dr Magnus Joelsson and colleagues from Sweden tested the hypothesis that smoking reduces the risk of pouchitis.
The research team investigated 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.
|29% of patients had had at least 1 episode of pouchitis|
|Scandanavian Journal of Gastroenterology|
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% completed the questionnaires.
The researchers found that 29% of these patients had had at least 1 episode of pouchitis.
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.
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.
Dr Joelsson's team concluded, “Smoking does not decrease the risk of pouchitis following ileal pouch anal anastomosis for ulcerative colitis.”
“In this respect the pathogenetic model of pouchitis, suggested to be a manifestation of ulcerative colitis, is not supported.”