Smoking is a risk factor and a contributor to many diseases. Scientists have discovered that smoking tends to worsen the effects of Crohn’s disease. The aetiology and pathogenesis of Crohn’s disease, however, is still unknown. The mechanism of the effect of smoking on the colon is also unknown. Pathogens might cause some changes in bowel motility and susceptibility but it is hard to predict the mechanism of those changes. Moreover, smoking may produce complex changes in immune function including reduced natural killer cell activity in peripheral blood leukocytes and decreased immunoglobulin concentration in the serum and saliva.
Furthermore, some studies have shown that patients with Crohn’s disease consume more refined sugar than normal healthy people. Other studies revealed that people with Crohn’s disease who consume more sugar in their diet show exacerbated symptoms compared to those who consume less sugar. Since nobody knows how sugar injures the intestine, doctors recommend their patients to eliminate sugar from their diet, or change their diet from a high-carbohydrate to a low-carbohydrate.
Now, we know that sugar and smoking are bad for patients with Crohn’s disease. The challenging question is what will happen if a patient with Crohn’s disease has a combination of both risk factors? Some studies showed that sugar intake and smoking were independent risk factors for Crohn’s disease, but a combined exposure did not result in a further increase of the risk. Some researchers think that these factors might operate through a common mechanism. I did my research trying to get an answer but i found nothing. I believe those people who figured out that there is no increase in risk if you combine both factors should work hard to figure out the mechanism behind this.
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Here is an article that relates with your post:
ReplyDeletehttp://gastro.dom.uab.edu/Fellow_Articles/OtherIBD/Cottone%20M.%20Smoking%20Habits%20and%20Recurrence%20in%20Crohn's%20Disease.pdf
It is intersting that this article states that "es-smokers run risk of recurrence that is similar to nonsmokers"
Here is a pretty good review which gives 4 possible mechanisms (at the end) explaining the association between IBD and smoking:
ReplyDeleteJ R Soc Med. 1992 April; 85(4): 214–216.
Cigarette smoking and its relationship to inflammatory bowel disease: a review.
M J Osborne and G P Stansby
Very interesting article. That got me reading -- Also interesting is the genetic component that may be involved in intestinal permeability (CARD15 3020insC). Long story short, it appears that mutations in the CARD15 gene, may result in a compromised intestinal lining - something that has long been thought to be a risk factor for CD.
ReplyDeleteS Buhner, C Buning, J Genschel, K Kling, D Herrmann, A Dignass, I Kuechler, S Krueger, H H-J Schmidt, H Lochs
NFLAMMATORY BOWEL DISEASE: Genetic basis for increased intestinal permeability in families with Crohn’s disease: role of CARD15 3020insC mutation?
Gut 2006;55:342-347
Thank you guys for posting the related articles. Well, we all know that a high-sugar diet and smoking individually have the effect of increasing the risk of getting Crohn's disease. We also sort of know about smoking and its mechanism in causing Crohn's disease, although not so much is known about how the increased sugar leads to the disease. The question is then: why is it when a patient combines both smoking and a high-sugar diet, there is no change in the condition?
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