Does active smoking really influence the course of Crohn's disease? A retrospective observational study

Hospital Universitari Germans Trias i Pujol, Badalona (Catalonia), Spain
Journal of Crohn s and Colitis (Impact Factor: 6.23). 04/2012; 7(4). DOI: 10.1016/j.crohns.2012.03.020
Source: PubMed


Background: Active smoking has been associated with a higher risk of developing Crohn's disease (CD). However, its impact on clinical outcomes has been controversial among studies.
Aims: To evaluate the influence of active smoking on initial manifestations of CD, the development of disease-related complications, and therapeutic requirements.
Methods: Patients diagnosed with CD within a ten-year period (1994–2003) were identified. Clinical and therapeutic features until October 2008 or loss of follow-up were recorded. Smoking status was assessed at each major disease-related event (e.g. penetrating and stricturing complications, perianal disease, intestinal resection, introduction of immunomodulators or biological agents).
Results: A total of 259 patients were included in the study with a median follow-up period of 91 months. At diagnosis, 50.5% were active smokers and only 12% of them quit smoking during follow-up, mostly after a major disease-related event occurred. Smoking at diagnosis was not associated with a particular CD presentation. Active smoking did not influence the development of strictures, intraabdominal and perianal penetrating complications, or increased resectional surgery, biological therapy or immunomodulators requirements.
Conclusions: Patients who develop CD while smoking seem to have a similar disease course to those who never smoked.

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