Smoking and inflammatory bowel diseases: what in smoking alters the course

• Published in: International journal of colorectal disease Vol. 25; no. 6; pp. 671 - 680
• Main Author: El-Tawil, A. M
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Berlin/Heidelberg : Springer-Verlag 01.06.2010; Springer-Verlag; Springer; Springer Nature B.V
• Subjects: Biological and medical sciences; Cigarettes; Crohn disease; Epidemiology; free radicals; Gas phase; Gastroenterology; Gastroenterology. Liver. Pancreas. Abdomen; Hepatology; Humans; Immune System - pathology; Inflammation; Inflammatory Bowel Diseases - epidemiology; Inflammatory Bowel Diseases - etiology; Inflammatory Bowel Diseases - physiopathology; Internal Medicine; Intestines - physiopathology; Lipid Peroxidation; Medical sciences; Medicine; Medicine & Public Health; nicotine; Other diseases. Semiology; Oxidative Stress; Permeability; Proctology; Review; Smoking; Smoking - adverse effects; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surgery; Tar phase; Tobacco, tobacco smoking; Toxicology; trace elements; Ulcerative colitis; Tar phase; Free radicals; Trace elements; Gas phase; Epidemiology; Crohn’s disease; Ulcerative colitis; Smoking; Nicotine; Tobacco smoking; Crohn's disease; Free radical; Inflammatory disease; Inflammatory bowel disease; Trace element; Crohn disease; Alkaloid; Gastroenterology; Digestive diseases; Intestinal disease
• ISSN: 0179-1958; 1432-1262
• DOI: 10.1007/s00384-010-0925-6

Epidemiological studies provide strong evidence to confirm the correlation between cigarette smoking and inflammatory bowel diseases. This relationship is proved to be positive in Crohn's disease and negative in ulcerative colitis. What in smoking alters the course of inflammatory bowel diseases is still a mystery. Different smoking parts have different and may be opponent actions. Smoking has dual effects. Some of its activities are, sometimes, constructive as they are working in an antagonistic manner to the mechanism of the disease, such as reducing rectal blood flow and accordingly less recruitments of inflammatory mediators to the area of inflammation, enhancement of mucosal production, and consequently, strengthening the membranes, and inhibition of pro-inflammatory mediators' liberation and activity in subjects with ulcerative colitis. Yet the outcome of smoking actions may be affected by the existence of other cofactors. Odd factors, such as shortage of zinc in subjects with Crohn's disease, may facilitate liberation of pro-inflammatory mediators and their activities and accordingly exacerbates symptoms.