Certain moronic cigarette advocates on the web are peeing their pants: there is evidence that nicotine is a helpful treatment for UC sufferers. In other words, "Yay cigarettes! Smoke a lot and your colitis will be okay!" Some of the bullshit facts quoted include:
1. Non-smokers are more likely to develop UC
2. Cigarettes provide relief to all UC sufferers
3. Your overall quality of life will improve if you take up smoking because then your UC won't hurt and cigarettes never add complications to anyone's health, especially folks who are using dysplasia-encouraging immunosuppressors.
I think this is the most oft-wrongly-interpreted information, and I'm about to add my own biased opinion to the mix.
(Just for the record, I've never seen House, I love Hugh Laurie, and I love/d/olove cigarettes. Here's a bucket of salt.)
First, point one oversimplifies what happens when UC first rears its bloody head; smoking causes a suppression of the immune system, much like some of the medications UCers take. I don't think that non-smokers are more likely to develop UC; a non-smoking 21-year-old male and a smoking 21-year-old male may have the same chances genetically speaking. It's just that cigarettes/nicotine act as a treatment, suppressing the outward signs of UC. When smokers quit, the suddenly-deprived bowel freaks the hell out.
This is directly related to point two, because not all UC sufferers are former or current smokers. It's unproven whether or not nicotine gives marked relief to UC patients who have never delighted in the cig funpark.
Third, some drugs such as Imuran (!) have been shown to possibly cause dysplasia, or abnormal growth or development of organs/cells (fingers growing out of legs! Um...all right, I wish), which can lead to cancer. Why, oh, why would one want to increase that possibility by adding carcinogens? Granted, the two may work on very different levels, but because the body is a integrated system I can't imagine the two would avoid each other.
Apparently, on an early episode of House, the good doctor prescribes cigarettes to a patient, saying studies have shown that "cigarette smoking is one of the most effective ways to control inflammatory bowel"... it is not said which specific IBD the patient has (Crohn's is also classed as IBD, and smoking can exacerbate Crohnies' symptoms) and cigarettes are lauded as "most effective?" They are cheap, yes. They will not keep you in remission, so I would not call that most effective. My personal experience is that now I've given up on a regular basis, my UC gets a little squirrelly if I indulge again.
They taste nice, though.
From Vegas Lights (at the bottom, soft pack heaven) to These Tasty Things, I miss them so much.
Even the crappy VL's at 1.69 per pack with their dopey roulette wheel packaging.
I miss them. But I don't delude myself thinking they're good for me.
In other news, I had some fascinating bathroom experiences yesterday. But they can wait...
House quotes from: House MD Guide: Blogs, Answers
Some medical info from:
Health Reference Center Academic
Hanauer, SB "Medical therapy of ulcerative colitis." The Lancet. v342, n.8868. 14 Aug 1993. p412
Srivastava ED et al. "Smoking, humoral immunity, and ulcerative colitis." Gut. v32, n.9 Sept 1991. p1016
Lashner BA et al. "Testing nicotine gum for ulcerative colitis patients..." Digestive Diseases and Sciences. v35, n.7 July 1990. p827
I couldn't agree less with your views on smoking and ulcerative colitis.
ReplyDeleteI gave up smoking 25 years ago and contracted U.C. within a year. I have taken steroids ever since (10-25mg p.d.) and, following 10 years on Azathioprine, contracted Non-Hodgkin's Lymphoma, grade 4B (there isn't a grade 5). I'm still around, 5 years later, despite a 30% survival statistic.
In the last couple of months I've smoked 4 cigarettes per day to try to control my U.C. It works extremely effectively: I'm currently on 5mg of prednisolone (down from 25mg) with perfect bowel function. I could cut down further, but for extreme body stiffness.
Initially I didn't want to smoke when my daughter visited (2/3 days per week) so tried nicotine gum, which did NOT work. I now nip out for a sly smoke instead.
I don't write this to suggest sufferers take up smoking: It's hellishly addictive, requiring military discipline to stay on 4 a day. And even this level is not risk free. I believe it's right for me as my long-term steroid use is potentially very dangerous.
Why does it work? My own layman's opinion is that my colitis is caused by a lack of mucous in the colon- it acts like a protective screen. Smoking certainly stimulates bronchial mucous. This might get into the gut by swallowing. Or maybe smoking stimulates systemic mucous production.
Please contact me if you want to discuss.
Bill
Hi Bill!
ReplyDeleteI have to say, your diagnosis story sounds similar to mine. I quit smoking a few months or so before my first UC flare and subsequent diagnosis.
However, my problem with "cigarettes as viable UC treatment" isn't that I think it can't work for people, it's that it was touted on House as being this trendy daring move! (As you say, you're not just smoking cigarettes, you're taking prednisolone - albeit a marvelously low dose, I'm envious! But your sole treatment is not cigarettes, which is how the thing was portrayed on the episode.)
I'm glad you've got your UC under control with your own personal regimen. It's really the hallmark of this disease that there's no standard perfect treatment for everyone afflicted, and I don't think it's wrong for people to experiment and come up with the best way for their own treatment. But I get annoyed with the way it's portrayed in pop culture; mostly, I dislike the way the show lumps UC under IBD, when while cigarette smoking has been proved to help ease UC symptoms (as you reiterate) it also can do a lot of damage to folks with Crohns, or maybe even people who DIDN'T smoke before their UC manifested.
Good luck. I'm glad to hear you're doing well even after the lymphoma, and after taking azathioprine for ten years. I've been taking it since...2006, I think? It's nice to hear from someone who's had experience with it.
(Oh, and yeah, people should know that House is for humor and not for actual medical treatment information. Hey, kind of like this blog. :) )
I quit smoking in 1988. 1 year later I developed UC. I tried asacol, pentasa, rowasa enema's, cort enema's with very little relief. After 9 year's of non smoking I had a decision to make, eliostomy or try smoking again? I choose smoking and the went into remission. 1 or 2 normal bowel movements vs. 15 to 20 bloody ones per day. I am not advocating that smoking is ok, I understand the risks however from a quality of life stand point I made the right decision.
ReplyDeleteGregg: so your sole treatment for UC right now is cigarettes? Are you taking any (other, ha ha) medications at all, or doing any sort of special diet? How far did you go up the medication scale - did you get to the harsh ones like infliximab?
ReplyDeleteI do agree that you have to do whatever treatment works best for you and calms your gut and UC symptoms, whether it's a lifestyle/diet change or a surgery.