Smoking not linked with increased pouchitis risk
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Current or past smoking was not associated with increased risk for the development of pouchitis in patients with ulcerative colitis, according to a meta-analysis published in Alimentary Pharmacology & Therapeutics.
Shannon Chang, MD, of the division of gastroenterology at NYU Langone Health, and colleagues wrote that the role of smoking in inflammatory bowel disease in somewhat well-established, but that is not the case in pouchitis.
“Smoking cigarettes has been associated with negative outcomes in Crohn's disease but with a protective effect in patients with ulcerative colitis,” they wrote. “The role of smoking in the development of pouchitis is less clear.”
Investigators searched the literature for studies that explored smoking as a risk factor for pouchitis among patients with UC or indeterminate colitis with a history of ileal pouch-anal anastomosis. They identified 15 studies comprising 2,276 patients that fit their criteria.
Compared with no smoking, a history of smoking was not associated with an increased risk for pouchitis (RR = 0.94; 95% CI, 0.76-1.18). Researchers did not find a risk for pouchitis when they compared current smokers (RR = 0.96; 95% CI, 0.7-1.24) and former smokers (RR = 0.96; 95% CI, 0.74-1.23) with non-smokers.
“This is important information to consider when counselling patients on the risks of smoking and pouchitis,” Chang and colleagues wrote. “Multicenter, prospective registries of [ileal pouch-anal anastomosis] patients are required to identify and evaluate predictors associated with the development of pouchitis.”
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