27/11/2020

Smoking helps Ulcerative Colitis – Is that a misnomer?

Smoking helps Ulcerative Colitis

Introduction

While entering cinema theatres, parks, hospitals, Malls….etc, You will encounter a “statutory warning” board showing “smoking causes cancer & smoking kills”

From our childhood onwards we too got tired of hearing our parents, teacher’s, elders and doctors advice. “Don’t smoke”, Smoking kills”, “Smoking costs your Life”,..etc. Are these people’s are wrong?.  Let’s see….

What is ulcerative colitis?

It is the chronic inflammatory disease of the bowel or large intestine of unknown etiology, Which causes severe abdominal pain, bloody stools and ulceration of large intestine, which is most frequently seen in teens & early 20s.

Smoking & Ulcerative Colitis

smoking helps ulcerative colitis dr house

If you watch House, In “Episode 5 of Season 1”,  you may remember a clinic scene where Dr. House prescribes a Mall Santa cigarettes for his tummy troubles. When I learned about this condition in med school, I was surprised to find that this was pretty legitimate.

According to the British Journal of Clinical Pharmacology, Incidence of Ulcerative Colitis is more in non- smokers than smokers means Smoking helps Ulcerative Colitis. Also they found that those patients resume smoking after the disease also experience significant improvement from the disease,

This prompted attempts to verify the hypothesis that nicotine might be the active component of smoking responsible for the beneficial effects on the course of the disease.

A very low concentration of nicotine in the form of gums, transdermal patches or rectal enemas along with conventional therapy (e.g, Mesalazine) found to be effective in 90% of the patients.

Mesalazine and Transdermal Patches (Nicotine patches)

Mechanism of action

As we all know, Nicotine receptors plays an important role in Neuromuscular junction, where Nicotine act as a full agonist,

It also has a good anti- inflammatory property, it stimulates colonic mucus & inhibits inflammatory cytokines thus playing a major role in Ulcerative Colitis.

But the exact mechanism of action is yet to known.

Adverse effects

Smoking helps Ulcerative Colitis Adverse effects

The plasma concentration of nicotine must be strictly maintained.

A very small increase in the concentration may produce nausea, dizziness, headache, sleeping disturbance and skin irritations. On overdose it produces severe CNS depression, lethargy & psychotic behaviour , It is also highly addictive and a potential carcinogen. Because of this many of the doctors doesn’t recommend Nicotine therapy for the treatment of Ulcerative colitis.

Conclusion

Smoke but be in control

One of the famous Tamil proverb which says “Aalavuku Meerinal Amirthamum Nanju” which means “Too much of anything is bad for Nothing” , Likewise, Nicotine at a very low concentration may be protective in Ulcerative Colitis (Smoking helps Ulcerative Colitis). On the other hand cigarette smoke contains highly concentrated nicotine and many other hazardous chemicals such as hydrogen cyanide, carbon monoxide, ammonia, which are potential carcinogens and produce lethal effects to the body.

Keeping this on mind, even though it is some what protective against ulcerative colitis one must avoid smoking or else it definitely pays back with hundreds of other disease which are inoperable & incurable, so please avoid smoking and don’t stick to this misconception.

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