משהו מפתיע על קרוהן ועישון מתוך מדסקייפ

WESTPORT, CT (Reuters Health) May 09 - Crohn's disease patients who are able to quit smoking for one year or longer have a significantly less severe disease course than those who continue to smoke, according to researchers in France. "Smoking cessation should be emphasized as a major therapeutic goal in the treatment of Crohn's disease, and management clinics for this disease should include evidence-based management of smoking cessation," Dr. Jacques Cosnes of Hopital Rothschild in Paris and colleagues recommend in the April issue of Gastroenterology. The investigators examined the effects of smoking cessation in 474 Crohn's disease patients who were current smokers. All patients were offered repeated counseling and access to a smoking cessation program. Twelve percent of the patients quit smoking for more than one year. Factors associated with smoking cessation included prior surgery, higher socioeconomic status, physician characteristics and the use of oral contraceptives. Quitters were significantly and substantially less likely to have disease flare-ups and to require costly steroid or immunosuppressive therapy than patients who continued smoking during a 29-month follow-up. In fact, the disease course in patients who quit smoking was similar during the study to that in Crohn's disease patients who had never smoked. On the other hand, patients in all three groups — quitters, current smokers and never smokers — had similar rates of excisional surgery. The authors suspect that longer follow-up would be needed to measure any significant difference between the groups for this outcome. "This is the first trial to assess the effect of smoking cessation in Crohn's disease," Dr. Cosnes' group writes. They conclude that this study demonstrates that smoking cessation is both feasible and beneficial in this population. אמיר

היה קצת קשה לקרוא ב"הפוכה" - משום מה אצלי כל פיסקה מופיעה הפוך - מסופה לתחילתה, אבל - עובדה ידועה מזמן מזמן היא שחולי קוליטיס שהפסיקו לעשן - עלולים להתלקח בחומרה יתרה, ושאחוז המעשנים לשעבר בקרב חולי קוליטיס הוא גבוה למדי, בעוד שבחולי קרוהן המצב בדיוק הפוך - עישון מחמיר את המחלה והפסקת עישון היא מומלצת ביותר. למה? ככה. זו אחת הסיבות לכך שיש נסיונות לטפל בחולי קוליטיס באמצעות "מדבקות" של ניקוטין, או מסטיק-ניקוטין כמו אלו שנותנים לנגמלים מעישון. המחשבה היתה שהניקוטין תורם לרגיעה בחולי קוליטיס. אני לא יודעת אם זה הוכח. כמו כל ה"תרופות" לקוליטיס - גם זה עוזר רק לחלק קטן ולא לכולם.