Smoking Causes Relapse Of Crohn’s Disease After Surgery

People with Crohn's disease are more likely to experience a recurrence after surgery if they continue to smoke, new research has found.

Crohn's disease is a serious bowel condition, which occurs when the immune system attacks the lining of the gut and bowel to cause severe inflammation. It results in abdominal pain, urgent diarrhea, sickness and profound lethargy.

Crohn’s Disease
Crohn’s disease or regional enteritis is an inflammatory bowel disease that involves the small intestine and causes abdominal pain, diarrhea and bleeding.

‘Identifying right therapies and educating people to make life-style changes which includes to quit smoking, can prevent Crohn's disease recurrence after surgery and also avoid patients having to undergo multiple operations.’

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Doctors recommend people with the condition stop smoking to avoid their illness worsening.

"Our study confirms that the most important thing somebody with Crohn's disease can do for their health is not to smoke," said Jack Satsangi, Professor at University of Edinburgh in Britain.

Most patients with Crohn's disease require surgery to remove the affected section of their bowel. Surgery is not curative, however, and the condition often relapses.

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A major type of inflammatory bowel disease (IBD) may be caused in part by genetic variants that prevent beneficial bacteria in the gut from doing their job.

The researchers also assessed whether a drug treatment that is commonly used in treating the disease is effective at preventing it from coming back after surgery.

They found that the therapy had limited beneficial effects for non-smokers in preventing relapse after surgery. It did, however, offer protection for smokers.

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A class of drugs called thiopurines have often been prescribed to patients after surgery to try to prevent relapse but until now, it was not clear whether the therapy offers any benefit.

The researchers conducted a trial of the therapy involving 240 people with Crohn's disease.

Combined Medical and Surgical Care Plan Improve Outcomes for Crohns Disease
Prior to the introduction of an immunosuppressant medication called infliximab in 1998, septic perianal Crohn's disease was typically treated with surgery.

Patients were monitored for three years after they had undergone surgery. Some 128 patients were treated with a drug from the thiopurine family called mercaptopurine and 122 were given a dummy medicine.

Only three of 29 smokers treated with the therapy experienced a relapse compared with 12 of 26 who received the dummy drug.

The rate of relapse in the non-smoking group was much lower and was unaffected by treatment with the medicine, showed the findings published in The Lancet Gastroenterology and Hepatology.

"There is an unmet need to identify therapies or life-style changes that prevent Crohn's disease recurrence after surgery to avoid patients having to undergo multiple operations," Satsangi said.

Source-Medindia