Smoking

Smoking effects ulcerative colitis and Crohn’s disease in different ways.

Smoking and Crohn’s disease

Patients who continue to smoke have a more severe course of disease with more complications; have a greater requirement of steroids and immunosuppressive medications; and are more likely to need surgery. This effect is more marked in women, and applies to ileal and colonic Crohn’s disease. Ex-smokers run a similar course of disease to non-smokers.

Smoking and ulcerative colitis

In ulcerative colitis smoking protects against the development of the disease; smokers run a more benign course than non smokers; and cessation of smoking is followed by an increase in disease activity, but without an obvious increase in colectomy rate.