Crohn’s patients who smoke ‘more likely to suffer relapse after surgery’

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Smokers with Crohn’s disease should quit the habit if they want to avoid a relapse after surgery, research has shown.

A new study has confirmed that smoking is strongly linked to a recurrence in the bowel condition.

Crohn’s occurs when the immune system attacks the lining of the gut and bowel, causing severe inflammation.

Patients are initially treated with a class of drugs called thiopurines, which dampen the immune system, and more than half require surgery to remove the affected section of their bowel.

A team at Edinburgh University found that the risk of relapse is higher for smokers.

As part of the study they also assessed whether thiopurines are effective at preventing the return of the condition after surgery.

Only three of 29 smokers treated with the therapy experienced a relapse within three years compared with 12 of 26 who received the dummy drug.

The rate of relapse among non-smokers was much lower and was unaffected by treatment with the medicine.

Professor Jack Satsangi, from Edinburgh University’s Centre of Genomics and Experimental Medicine, said: “There is an unmet need to identify therapies or lifestyle changes that prevent Crohn’s disease recurrence after surgery to avoid patients having to undergo multiple operations.

“Our study confirms that the most important thing somebody with Crohn’s disease can do for their health is not to smoke.

“People who are unable to quit smoking are at high risk of relapse after surgery and may begin treatment with thiopurines immediately after their operation.

“For non-smokers, however, we found that thiopurines offer little benefit at preventing relapse after surgery.

“For these patients, close monitoring in the first year is the best course of action rather than immediate drug therapy.”

The study is published in The Lancet Gastroenterology and Hepatology journal.

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