Ulcerative colitis (UC) is largely a disease of non-smokers. Improvement of symptoms has been seen in patients resuming smoking, having previously given up.
The reason for this apparent improvement has been attributed to the nicotine content of the cigarette and reasons why nicotine may be beneficial include:
Studies have shown an improvement in symptoms of patients using nicotine patches.
A recent study was conducted on patients with known left-sided colitis using nicotine patches of 5mg increasing to 15mg doses (equivalent to 5-15 cigarettes) over 6 days. This was compared to the effects of a placebo. The dose was increased to 25mg if there was no response after two weeks. An improvement of symptoms was seen in both groups, but the nicotine group showed greater improvement.
The study does, however, has some major flaws:
Whilst being able to demonstrate an improvement of the symptoms of UC in smokers, evidence of the true biological effect of nicotine, or a clear mechanism for its effectiveness, was lacking.
Proximal (right-sided) constipation is frequently associated with distal (left-sided) colitis and relapses of the disease. Nicotine has a known laxative effect on the bowel which may explain some of the benefits of smoking in maintaining remission in UC.
However, smoking has a detrimental effect on general health, such as:
It would, therefore, seem more prudent to take a more simple and conventional laxative such as Fybogel, Normacol, methylcellulose (Celevac) or lactulose, together with a sensible eating plan, rather than smoking cigarettes.