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Postgraduate Medical Journal 2000;76:273-279; doi:10.1136/pmj.76.895.273
Copyright © 2000 The Fellowship of Postgraduate Medicine.
Postgrad Med J 2000;76:273-279 ( May )

Review

Role of smoking in inflammatory bowel disease: implications for therapy Gareth A O Thomas, John Rhodes, John T Green, Charles Richardson

Department of Gastroenterology, Ward A7, University Hospital of Wales, Heath Park, Cardiff CF4 4QW, Wales, UK

Correspondence to: Dr Thomas

Submitted 21 May 1999; Accepted 6 September 1999

The relationship between smoking and inflammatory bowel disease is now firmly established but remains a source of confusion among both patients and doctors. It is negatively associated with ulcerative colitis but positively associated with Crohn's disease. In addition, it has opposite influences on the clinical course of the two conditions with benefit in ulcerative colitis but a detrimental effect in Crohn's disease. These differences have been the subject of much interest and scrutiny with the hope that they may offer some insight into the pathogenesis of the two conditions and possibly lead to alternative therapeutic options. Nicotine is probably the principal active ingredient in smoking responsible for the association; trials have shown it to be of some benefit in ulcerative colitis, but further research is required to establish its therapeutic role, and the relevant mechanisms responsible for its action. In this article, we review the role of smoking in inflammatory bowel disease and its implication for therapy.


Keywords: inflammatory bowel disease; smoking; nicotine; Crohn's disease

© 2000 by The Fellowship of Postgraduate Medicine
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