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- Title
Clinical Status of Ulcerative Colitis in Patients Who Smoke.
- Authors
Green, J. T.; Rhodes, J.; Ragunath, K.; Thomas, G. A. O.; Williams, G. T.; Mani, V.; Feyerabend, C.; Russell, M. A. H.
- Abstract
Objectives: Ulcerative colitis (UC) is largely a disease of nonsmokers. There are few patients who are current smokers, but we have identified a group and reviewed their clinical status, disease activity, and nicotine exposure to examine whether they remain well controlled while smoking. Methods: Fifty-one patients from three centers with verified UC were reviewed. Results: Thirty of the group were men; mean age 50 yr, with a mean age of onset of 37 yr. Twenty-two patients had proctosigmoid disease, 12 involvement of left colon, and 17 total colitis. All were current smokers; 41 were cigarette smokers averaging 17 daily. At the onset of colitis 30 were non-smokers, 25 of them were ex-smokers and 19 developed colitis within 2 yr of stopping smoking. Twenty-eight believed smoking improved disease activity and none felt smoking had a detrimental effect on their UC. Eleven were receiving no medication for UC, 40 were receiving 5-ASA (5-aminosalicylic acid) preparations, and only two took oral steroids. All were in clinical remission, with the exception of one patient; mean St. Marks score was 1.5, out of a possible total of 22. Sigmoidoscopic grades were inactive in all patients except three. Histological assessment showed significant activity in only five. Median serum nicotine was 8 ng/ml (range, 0.4-24.4), median serum cotinine 180 ng/ml (range, 20-453), with corresponding salivary cotinine of 255 ng/ml (range, 34-683). Median rise in nicotine 2 min after a cigarette in 35 patients was 12.1 ng/ml (range, 0.4-44). Conclusions: Because most current smokers with UC have inactive disease, smoking may contribute to the clinical remission in these patients.
- Subjects
ULCERATIVE colitis; CIGARETTE smokers; SALICYLIC acid; STEROIDS; NICOTINE; SMOKING; GASTROINTESTINAL diseases
- Publication
American Journal of Gastroenterology (Springer Nature), 1998, Vol 93, Issue 9, p1463
- ISSN
0002-9270
- Publication type
Article
- DOI
10.1111/j.1572-0241.1998.00464.x