Smoking and the Risk of Pouchitis in Ulcerative Colitis Patients with Ileal Pouch-Anal Anastomosis

Venkata Subhash Gorrepati, August Stuart, Susan Deiling, Walter Koltun, Andrew Tinsley, Emmanuelle Williams, Matthew Coates

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background Ulcerative colitis (UC) patients who undergo proctocolectomy with ileal pouch-anal anastomosis (IPAA) may develop pouchitis, a poorly understood inflammatory condition. There is controversy over whether tobacco use can protect against pouchitis. We undertook this investigation to further evaluate whether smoking reduces the risk of developing pouchitis and to determine whether other previously associated clinical factors change the risk for pouchitis. Methods We performed a retrospective analysis using a consented inflammatory bowel disease (IBD) natural history registry between the years 1995-2015 from a single tertiary care referral center. Demographic data, medical history, surgical information, medication use, laboratory data, and smoking history were abstracted. Former smokers had quit for at least 1 year. The primary end point was development of pouchitis. Results Of the 353 UC patients with IPAA in this study, 126 (35.6%) developed pouchitis. Prior tobacco use (P < 0.0001) was more common in patients who developed pouchitis. Former and active smokers were more likely to develop pouchitis compared with those without a history of tobacco use (63.4% vs 27.3% respectively, P < 0.001). There was no significant difference in active smoking rate between those without pouchitis and the group that did develop pouchitis. Multivariate analysis demonstrated that the only independent risk factor associated with pouchitis was a history of tobacco use. Conclusions These results suggest that smoking cessation may increase the likelihood of developing pouchitis in tobacco users with UC and IPAA, but active smoking does not seem to be more effective in preventing this condition.

Original languageEnglish (US)
Pages (from-to)2027-2032
Number of pages6
JournalInflammatory bowel diseases
Volume24
Issue number9
DOIs
StatePublished - Aug 16 2018

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Pouchitis
Colonic Pouches
Ulcerative Colitis
Smoking
Tobacco Use
Tertiary Care Centers
Smoking Cessation
Natural History
Inflammatory Bowel Diseases
Tobacco
Registries

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Gastroenterology

Cite this

@article{451af8f8783a441d848c4f7d9a15da8d,
title = "Smoking and the Risk of Pouchitis in Ulcerative Colitis Patients with Ileal Pouch-Anal Anastomosis",
abstract = "Background Ulcerative colitis (UC) patients who undergo proctocolectomy with ileal pouch-anal anastomosis (IPAA) may develop pouchitis, a poorly understood inflammatory condition. There is controversy over whether tobacco use can protect against pouchitis. We undertook this investigation to further evaluate whether smoking reduces the risk of developing pouchitis and to determine whether other previously associated clinical factors change the risk for pouchitis. Methods We performed a retrospective analysis using a consented inflammatory bowel disease (IBD) natural history registry between the years 1995-2015 from a single tertiary care referral center. Demographic data, medical history, surgical information, medication use, laboratory data, and smoking history were abstracted. Former smokers had quit for at least 1 year. The primary end point was development of pouchitis. Results Of the 353 UC patients with IPAA in this study, 126 (35.6{\%}) developed pouchitis. Prior tobacco use (P < 0.0001) was more common in patients who developed pouchitis. Former and active smokers were more likely to develop pouchitis compared with those without a history of tobacco use (63.4{\%} vs 27.3{\%} respectively, P < 0.001). There was no significant difference in active smoking rate between those without pouchitis and the group that did develop pouchitis. Multivariate analysis demonstrated that the only independent risk factor associated with pouchitis was a history of tobacco use. Conclusions These results suggest that smoking cessation may increase the likelihood of developing pouchitis in tobacco users with UC and IPAA, but active smoking does not seem to be more effective in preventing this condition.",
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Smoking and the Risk of Pouchitis in Ulcerative Colitis Patients with Ileal Pouch-Anal Anastomosis. / Gorrepati, Venkata Subhash; Stuart, August; Deiling, Susan; Koltun, Walter; Tinsley, Andrew; Williams, Emmanuelle; Coates, Matthew.

In: Inflammatory bowel diseases, Vol. 24, No. 9, 16.08.2018, p. 2027-2032.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Smoking and the Risk of Pouchitis in Ulcerative Colitis Patients with Ileal Pouch-Anal Anastomosis

AU - Gorrepati, Venkata Subhash

AU - Stuart, August

AU - Deiling, Susan

AU - Koltun, Walter

AU - Tinsley, Andrew

AU - Williams, Emmanuelle

AU - Coates, Matthew

PY - 2018/8/16

Y1 - 2018/8/16

N2 - Background Ulcerative colitis (UC) patients who undergo proctocolectomy with ileal pouch-anal anastomosis (IPAA) may develop pouchitis, a poorly understood inflammatory condition. There is controversy over whether tobacco use can protect against pouchitis. We undertook this investigation to further evaluate whether smoking reduces the risk of developing pouchitis and to determine whether other previously associated clinical factors change the risk for pouchitis. Methods We performed a retrospective analysis using a consented inflammatory bowel disease (IBD) natural history registry between the years 1995-2015 from a single tertiary care referral center. Demographic data, medical history, surgical information, medication use, laboratory data, and smoking history were abstracted. Former smokers had quit for at least 1 year. The primary end point was development of pouchitis. Results Of the 353 UC patients with IPAA in this study, 126 (35.6%) developed pouchitis. Prior tobacco use (P < 0.0001) was more common in patients who developed pouchitis. Former and active smokers were more likely to develop pouchitis compared with those without a history of tobacco use (63.4% vs 27.3% respectively, P < 0.001). There was no significant difference in active smoking rate between those without pouchitis and the group that did develop pouchitis. Multivariate analysis demonstrated that the only independent risk factor associated with pouchitis was a history of tobacco use. Conclusions These results suggest that smoking cessation may increase the likelihood of developing pouchitis in tobacco users with UC and IPAA, but active smoking does not seem to be more effective in preventing this condition.

AB - Background Ulcerative colitis (UC) patients who undergo proctocolectomy with ileal pouch-anal anastomosis (IPAA) may develop pouchitis, a poorly understood inflammatory condition. There is controversy over whether tobacco use can protect against pouchitis. We undertook this investigation to further evaluate whether smoking reduces the risk of developing pouchitis and to determine whether other previously associated clinical factors change the risk for pouchitis. Methods We performed a retrospective analysis using a consented inflammatory bowel disease (IBD) natural history registry between the years 1995-2015 from a single tertiary care referral center. Demographic data, medical history, surgical information, medication use, laboratory data, and smoking history were abstracted. Former smokers had quit for at least 1 year. The primary end point was development of pouchitis. Results Of the 353 UC patients with IPAA in this study, 126 (35.6%) developed pouchitis. Prior tobacco use (P < 0.0001) was more common in patients who developed pouchitis. Former and active smokers were more likely to develop pouchitis compared with those without a history of tobacco use (63.4% vs 27.3% respectively, P < 0.001). There was no significant difference in active smoking rate between those without pouchitis and the group that did develop pouchitis. Multivariate analysis demonstrated that the only independent risk factor associated with pouchitis was a history of tobacco use. Conclusions These results suggest that smoking cessation may increase the likelihood of developing pouchitis in tobacco users with UC and IPAA, but active smoking does not seem to be more effective in preventing this condition.

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U2 - 10.1093/ibd/izy097

DO - 10.1093/ibd/izy097

M3 - Article

VL - 24

SP - 2027

EP - 2032

JO - Inflammatory Bowel Diseases

JF - Inflammatory Bowel Diseases

SN - 1078-0998

IS - 9

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