Inflammatory bowel disease and smoking. A review of epidemiology, pathophysiology, and therapeutic implications
Article first published online: 14 DEC 2006
Copyright © 2004 Crohn's & Colitis Foundation of America, Inc.
Inflammatory Bowel Diseases
Volume 10, Issue 6, pages 848–859, November 2004
How to Cite
Birrenbach, T. and Böcker, U. (2004), Inflammatory bowel disease and smoking. A review of epidemiology, pathophysiology, and therapeutic implications. Inflamm Bowel Dis, 10: 848–859. doi: 10.1097/00054725-200411000-00019
- Issue published online: 14 DEC 2006
- Article first published online: 14 DEC 2006
- Manuscript Accepted: 7 JUN 2004
- Manuscript Received: 1 APR 2004
- Crohn's disease;
- inflammatory bowel disease;
- ulcerative colitis
The relationship between smoking behavior and inflammatory bowel disease (IBD) is complex. While Crohn's disease (CD) is associated with smoking and smoking has detrimental effects on the clinical course of the disease, ulcerative colitis (UC) is largely a disease of nonsmokers and former smokers. Furthermore, cigarette smoking may even result in a beneficial influence on the course of ulcerative colitis. The potential mechanisms involved in this dual relationship include changes in humoral and cellular immunity, cytokine and eicosanoid levels, gut motility, permeability, and blood flow, colonic mucus, and oxygen free radicals. Nicotine is assumed to be the active moiety. The differential therapeutic consequences comprise the cessation of smoking in CD and, so far, clinical trials using nicotine in different forms of application for UC. In this article, we review the relationship between cigarette smoking and IBD, considering epidemiological, pathogenetic, and clinical aspects.