Table 1

Implications for therapy of ulcerative colitis and Crohn's disease

Question Answer
Ulcerative colitis
Encourage patient to commence smoking to improve symptoms and clinical course?No, but patients should be told the facts
Consider nicotine patches in active disease?Ye s, worth considering in patients with mild to moderate disease not responding to conventional treatment (particularly if urgency is a major problem)
Consider nicotine enema in active disease?Ye s, in patients with mild to moderate disease with side effects on transdermal nicotine
Nicotine patches for maintenance of remissionNot on available data but could be revised with future trials
Crohn's disease
Encourage patient to stop smoking to improve outcome and help maintain remission?Ye s, one of the most useful steps that can be taken by the patient to help the natural history of their disease