Cigarette Smoking and Appendectomy are Risk Factors for Extraintestinal Manifestations in Ulcerative Colitis

Manguso, F.; Sanges, M.; Staiano, T.; Gargiulo, S.; Nastro, P.; Gargano, D.; Somma, P.; Mansueto, G.; Peluso, R.; Scarpa, R.; D'Armiento, F. P.; Astarita, C.; Ayala, F.; Renda, A.; Mazzacca, G.; D'Arienzo, A.
February 2004
American Journal of Gastroenterology;Feb2004, Vol. 99 Issue 2, p327
Academic Journal
OBJECTIVE: Two common factors, cigarette smoking and appendectomy, have been found to play a role in ulcerative colitis (UC). Data on their role in the development of extraintestinal manifestations (EIM) are scarce.METHODS: The relationship between cigarette smoking, appendectomy, and EIM was examined in a prospective study involving 535 (M/F= 319/216) consecutive UC patients followed up for 18 yr. We considered the major EIM: seronegative spondyloarthropathy, pyoderma gangrenosum/erythema nodosum, acute anterior uveitis, and primary sclerosing cholangitis. We excluded patients with a history of EIM or those colectomized before study entry, ex-smokers, and those who started to smoke during the course of UC.RESULTS: In UC patients, seronegative spondyloarthropathy and dermatologic complications were found increased in smokers (p<0.0001;p= 0.001) or in subjects with appendectomy (p= 0.0003;p= 0.02), while acute anterior uveitis and primary sclerosing cholangitis did not differ. The Kaplan-Meier analysis showed 18-yr rates for EIM of 71% in smokers and 45% in nonsmokers (log-rank test,p= 0.0001), and of 85% in patients with appendectomy and 48% in those without (p= 0.0001). Cox proportional-hazard model showed that cigarette smoking and appendectomy are independent factors promoting EIM. In smokers with appendectomy the adjusted hazard ratio (3.197, 95% CI 1.529–6.684) was higher than in patients with appendectomy alone (2.617, 95% CI 1.542–4.442) or smoking alone (1.947, 95% CI 1.317–2.879).In UC patients, appendectomy and cigarette smoking are prognostic factors for the development of EIM. The unfavorable effect of cigarette smoking on EIM is additive to that of appendectomy.


Related Articles

  • Passive Smoking is Associated with an Increased Risk of Developing Inflammatory Bowel Disease in Children. Lashner, Bret A.; Shaheen, Nicholas J.; Hanauer, Stephen B.; Kirschner, Barbara S. // American Journal of Gastroenterology;Mar1993, Vol. 88 Issue 3, p356 

    Adult cigarette smoking is associated with the development of Crohn's disease and protection from the development of ulcerative colitis. Children usually are nonsmokers whose risk of developing inflammatory bowel disease (IBD) may he related to passive smoking. The purpose of this matched...

  • Appendectomy and the Development of Ulcerative Colitis: Results of a Metaanalysis of Published Case-Control Studies. Koutroubakis, I. E.; Vlachonikolis, I. G. // American Journal of Gastroenterology;Jan2000, Vol. 95 Issue 1, p171 

    OBJECTIVE: Numerous epidemiological studies have been performed to determine risk factors that might contribute to the development of ulcerative colitis (UC). Recent studies have focused on the role of appendectomy in the disease's pathogenesis. This report aims to review and analyze the degree...

  • A retrospective, case-control study on traditional environmental risk factors in inflammatory bowel disease in Vukovar-Srijem County, north-eastern Croatia, 2010. Vcev, Aleksandar; Pezerovic, Davorin; Jovanovic, Zeljko; Nakic, Darko; Vcev, Ivan; Majnarić, Ljiljana // Wiener Klinische Wochenschrift;May2015, Vol. 127 Issue 9/10, p345 

    Background: Traditional environmental risk factors in inflammatory bowel disease (IBD), ulcerative colitis (UC) and Crohn's disease (CD), were examined as part of the retrospective epidemiologic study conducted in Vukovar-Srijem County, north-eastern Croatia in 2010. The geographical variations...

  • Pattern of tobacco use among the Iranian adult population: results of the national Survey of Risk Factors of Non-Communicable Diseases (SuRFNCD-2007).  // Tobacco Control;Apr2010, Vol. 19 Issue 2, p125 

    The article studies tobacco use among adults in Iran. According to the third national Survey of Risk Factors of Non-Communicable Diseases (SuRFNCD-2007) based on responses from Iranian citizens aged 15-64 years old, there was a 14.8% overall prevalence rate of tobacco smoking, with most smokers...

  • Environmental Triggers of IBD. Kaplan, Gilaad G.; Molodecky, Natalie; Panaccione, Remo // Inflammatory Bowel Disease Monitor;2010, Vol. 11 Issue 2, p49 

    Crohn's disease and ulcerative colitis (UC) are chronic inflammatory disorders of the gastrointestinal tract that are believed to occur in genetically susceptible individuals who are exposed to environmental triggers. A number of environmental risk factors have been studied such as smoking,...

  • PREDICTING OUTCOME AND RISK ASSESSMENT IN SEVERE ULCERATIVE COLITIS. Ho, G.T.; Mowat, C.; Goddard, C.J.R.; Fennell, J.M.; Shah, N.B.; Prescott, R.P.; Satsangi, J. // Gut;Apr2003 Supplement 1, Vol. 52, pA69 

    Backgrounds/Aims: The rate of failure of medical therapy in severe ulcerative colitis (UC) remains high (30-40%). We have identified predictor factors associated with poor outcome in patients presenting with severe attacks of UC and devised a numerical scoring system that categorises patients by...

  • Smoking and inflammatory bowel diseases: what in smoking alters the course? El-Tawil, A. M. // International Journal of Colorectal Disease;Jun2010, Vol. 25 Issue 6, p671 

    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...

  • Smoking and Inflammatory Bowel Disease: A Meta-analysis. Mahid, Suhal S.; Minor, Kyle S.; Soto, Roberto E.; Hornung, Carlton A.; Galandiuk, Susan // Mayo Clinic Proceedings;Nov2006, Vol. 81 Issue 11, p1462 

    OBJECTIVE: To assess whether there is a true effect of smoking on the 2 most prevalent forms of inflammatory bowel disease (IBD): Crohn disease (CD) and ulcerative colitis (UC). METHODS: For this meta-analysis, we searched multiple health care databases, including MEDLINE and EMBASE (January...

  • GI distension in severe ulcerative colitis. Latella, Giovanni; Vernia, Piero; Viscido, Angelo; Frieri, Giuseppe; Cadau, Giuseppina; Cocco, Andrea; Cossu, Andrea; Tomei, Ernesto; Caprilli, Renzo // American Journal of Gastroenterology;May2002, Vol. 97 Issue 5, p1169 

    OBJECTIVES:In previous retrospective studies in patients with severe ulcerative colitis (UC), small bowel distension was found to characterize a subgroup of patients at higher risk for both toxic megacolon (TMC) and multiple organ dysfunction syndrome (MODS). In this study we prospectively...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics