Smoking usually comes with negative consequences, except maybe for ulcerative colitis. Find out how nicotine may reduce your ulcerative colitis symptoms. It's not often that you hear anything positive about cigarette smoking, but the nicotine in cigarettes may actually be good for ulcerative colitis. The link between smoking and ulcerative colitis goes back to the '70s and '80s, when researchers noticed that they had very few smokers in their ulcerative colitis studies. Since then, numerous studies have confirmed that ulcerative colitis is mostly a disease of non-smokers and former smokers. "There is over 30 years of research showing that ulcerative colitis is less common in smokers. Only about 10 percent of people with ulcerative colitis are smokers compared to the general population, which is about 25 to 30 percent smokers," says Bret Lashner, MD, a gastroenterologist and director of the Center for Inflammatory Bowel Disease in the department of gastroenterology at the Cleveland Clinic in Ohio. Research on Smoking and Ulcerative Colitis A review of published studies on ulcerative colitis, smoking, and nicotine that recently appeared in the journal Alimentary Pharmacology and Therapeutics finds these key results: Smoking protects you from developing ulcerative colitis. If you are a smoker and you get ulcerative colitis, your disease is less severe. If you quit smoking, your risk of getting ulcerative colitis increases within two years. The more you smoke, the less likely you are to get ulcerative colitis. If you use a nicotine patch or nicotine gum to treat active ulcerative colitis, you tend to get better. Does this mean smoking is actually good if you have ulcerative colitis or if you want to prevent it? Not really, says Dr. Lashner, "Smoking is still too harmful for your health, with or without ulcerative colitis. I would never advise anyone to smoke." Lashner has also given up on the idea of using nicotine gum or a nicotine patch to treat ulcerative colitis. "I did a study on it years ago. It helps keep symptoms under control, but nicotine has side effects, especially in non-smokers. I'm a never smoker. I tried one square of gum, and I couldn't stand it. Patients in the study had to take up to ten squares. I decided the risk of addiction to the nicotine and the side effects are not worth any improvement that you might get," he stresses. Why Does Smoking Help Ulcerative Colitis? Why smoking helps ulcerative colitis is not an easy question to answer because the effects of smoking differ between digestive diseases. To begin with, ulcerative colitis and Crohn's disease are both inflammatory bowel diseases (IBD), yet smoking is awful for Crohn's. "The statistics for smoking are exactly opposite," says Lashner. "Fifty percent of people with Crohn's are or were smokers, and smoking makes their disease worse in almost every way." Here are some theories as to why smoking helps ulcerative colitis: Nicotine in tobacco smoke may suppress the immune system and decrease inflammation in ulcerative colitis. Nicotine and other chemicals in cigarette smoke may increase the production of mucous in the part of the colon where ulcerative colitis usually starts and serves as a protective barrier. Nicotine releases a chemical called nitric acid that may reduce muscle activity in the colon and reduce ulcerative colitis spasms. An article in the journal Canadian Family Physician lends some support to the immune suppression theory. It presents a case study of a 61-year-old man with psoriasis who keeps returning to his doctor for nicotine patches even though he quit smoking many years earlier. The man's history reveals that he quit smoking four times with the help of nicotine patches starting at age 54. Each time he stopped smoking and stopped using the nicotine patches, his psoriasis flared up. Each time he started smoking or using the patch, his psoriasis went away. A review of the literature suggests that nicotine blocks the release of chemicals in the body that cause inflammation and that these chemicals, called pro-inflammatory mediators, are similar in both ulcerative colitis and psoriasis. "There have been lots of studies and lots of theories, but why smoking is good for ulcerative colitis and bad for Crohn's disease is still an open question. Another mystery is that people with Crohn's disease have a terrible time trying to quit smoking, even though smoking makes their disease worse," says Lashner. For now, smoking is still bad for everybody in the long run. "I warn smokers with ulcerative colitis that quitting may cause a flare of their symptoms, but we can handle that with medications. I still urge them to quit," says Lashner. Source
