I was wondering, my aunt has Colitis and she is a frequent smoker. Just recently she has been trying to quit smoking by using the nicotine patch. As she slowly comes off the patch her colitis gets worse and worse. Alot of blood in her stools, etc. She wants to quit smoking but the colitis bothers her so much that she is thinking of going back to smoking to calm down the colitis. Is there anything else that she can do? Thanks.
REPLY:
It is known that smokers seem to have a lower incidence of ulcerative colitis; some have postulated that smoking somehow effects patients with colitis to reduce symptoms or to make the disease less likely. This is certainly not a reason to smoke and smokers with Crohn's disease actually do much worse than non-smokers, especially women.
It is not clear in the case of your aunt if we are seeing part of the phenomenon described above or if some of the stress that smokers experience when they try to end their addiction is aggravating her inflammatory bowel disease.
She should certainly be encouraged to continue to try to give up smoking for all of the reasons well known to us all.
I would suggest that she discuss this situation with her gastroenterologist (or whoever she sees for the treatment of her colitis). Perhaps she will require an adjustment to her colitis medications. Her doctor may want to keep her on the patch a bit longer than other patients until the colitis can be better controlled. It may also be worthwhile to check and see if there is another reason for this flare-up in her colitis which is totally unrelated to her efforts to stop smoking (which should be encouraged).
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Bruce Sckolnick, M.D.
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