H Tarik Kani1,2, Daryl Ramai3, Ellen Caniglia4, David Hudesman2, Jordan Axelrad2, Joseph Nicholson5, Simon Hong2, Shannon Chang2. 1. Division of Gastroenterology, School of Medicine, Marmara University, Istanbul, Turkey. 2. Division of Gastroenterology, New York University Langone Health, New York, NY, USA. 3. Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, NY, USA. 4. Department of Population Health, New York University Langone Health, New York, NY, USA. 5. NYU Health Sciences Library, New York University Langone Health, New York, NY, USA.
Abstract
BACKGROUND: Ileal pouch-anal anastomosis is a common surgical procedure in patients with an initial diagnosis of ulcerative colitis or indeterminate colitis. Tobacco smoking has been associated with protection from onset of ulcerative colitis. Smoking has been reported to be both a protective factor and a risk factor for the development of pouchitis. AIM: To examine the influence of smoking on the risk of pouchitis. METHODS: We identified 15 studies evaluating smoking as a risk factor for developing pouchitis in ulcerative colitis or indeterminate colitis patients with a history of ileal pouch-anal anastomosis in a systematic search performed from inception through May 4, 2020. A meta-analysis was then performed using a random-effects model to generate risk ratios (RR) and 95% confidence intervals (CI). RESULTS: A history of smoking compared with never smoking was not associated with an increased risk of developing pouchitis (RR = 0.94, 95% CI 0.76-1.18, I2 = 73.7%). There was also no significant risk of pouchitis when comparing current smokers vs nonsmokers (RR = 0.93, 95% CI 0.70-1.24, I2 = 78.5%) and former smokers vs nonsmokers (RR = 0.96, 95% CI 0.74-1.23, I2 = 78.5%). CONCLUSIONS: Smoking, past or present, is not associated with an increased risk for the development of pouchitis in patients with ulcerative colitis or indeterminate colitis.
BACKGROUND: Ileal pouch-anal anastomosis is a common surgical procedure in patients with an initial diagnosis of ulcerative colitis or indeterminate colitis. Tobacco smoking has been associated with protection from onset of ulcerative colitis. Smoking has been reported to be both a protective factor and a risk factor for the development of pouchitis. AIM: To examine the influence of smoking on the risk of pouchitis. METHODS: We identified 15 studies evaluating smoking as a risk factor for developing pouchitis in ulcerative colitis or indeterminate colitispatients with a history of ileal pouch-anal anastomosis in a systematic search performed from inception through May 4, 2020. A meta-analysis was then performed using a random-effects model to generate risk ratios (RR) and 95% confidence intervals (CI). RESULTS: A history of smoking compared with never smoking was not associated with an increased risk of developing pouchitis (RR = 0.94, 95% CI 0.76-1.18, I2 = 73.7%). There was also no significant risk of pouchitis when comparing current smokers vs nonsmokers (RR = 0.93, 95% CI 0.70-1.24, I2 = 78.5%) and former smokers vs nonsmokers (RR = 0.96, 95% CI 0.74-1.23, I2 = 78.5%). CONCLUSIONS: Smoking, past or present, is not associated with an increased risk for the development of pouchitis in patients with ulcerative colitis or indeterminate colitis.
Authors: Edward L Barnes; Joshua Hudson; Scott Esckilsen; Bharati Kochar; Michael D Kappelman; Millie D Long; Mark Koruda; Robert S Sandler; Hans H Herfarth Journal: Inflamm Intest Dis Date: 2021-10-07