Editorial
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Aug 21, 2011; 17(31): 3567-3574
Published online Aug 21, 2011. doi: 10.3748/wjg.v17.i31.3567
Management of Crohn’s disease in smokers: Is an alternative approach necessary?
Pilar Nos, Eugeni Domènech
Pilar Nos, Gastroenterology Unit, La Fe University Hospital, 46009 Valencia, Spain
Eugeni Domènech, Digestive Disease Department, Germans Trias i Pujol Hospital, 08916 Badalona, Spain
Pilar Nos, Eugeni Domènech, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
Author contributions: Nos P and Domènech E contributed equally to this work.
Supported by CIBEREHD, funded by the Instituto de Salud Carlos III, from the Spanish Ministry of Health
Correspondence to: Pilar Nos, MD, PhD, Gastroenterology Unit, La Fe University Hospital, Avda, Campanar, 21, 46009 Valencia, Spain. nos_pil@gva.es
Telephone: +34-96-3622700 Fax: +34-96-1973065
Received: August 2, 2010
Revised: September 1, 2010
Accepted: September 8, 2010
Published online: August 21, 2011
Abstract

Inflammatory bowel disease is a chronic condition with a pathogenic background that involves both genetic and environmental factors. Although important progress has been made regarding the former in the last decade, scarce knowledge is available for the latter. In this sense, smoking remains the most important environmental factor in IBD. Active smoking increases the risk of developing Crohn’s disease (CD). Moreover, CD patients who start or continue smoking after disease diagnosis are at risk for poorer outcomes such as higher therapeutic requirements and disease-related complications, as compared to those patients who quit smoking or who never smoked. However, the harmful effect of active smoking is not uniform in all patients or in all clinical scenarios. Interventions designed to facilitate smoking cessation may impact the course of the disease. In this article, the available evidence of the deleterious effects of smoking on CD is reviewed in detail, and alternative therapeutic approaches to CD in smokers are proposed.

Keywords: Tobacco; Crohn’s disease; Therapy; Smoking cessation; Recurrence; Complications