Smokers More Prone to Relapse After Crohn's Surgery
Research supports mercaptopurine for smokers, but not for nonsmokers
FRIDAY, Sept. 2, 2016 (HealthDay News) -- Smoking increases the risk that Crohn's disease patients will experience clinical recurrence after bowel surgery, according to research published online Aug. 30 in The Lancet Gastroenterology and Hepatology.
The study included 240 Crohn's disease patients in the United Kingdom who were followed for three years after bowel surgery. The investigators also assessed whether mercaptopurine is effective in prevention of relapse after surgery.
Clinical recurrence was found to be significantly more common in smokers. The team also found mercaptopurine effective in preventing postoperative clinical recurrence of Crohn's disease, but only in smokers.
"Treatment with mercaptopurine to delay or prevent postoperative recurrence was particularly effective in people who continue to smoke; thus, in smokers, thiopurine treatment seems to be justified in the early postoperative period," the authors conclude. "In non-smokers, the data do not provide a sufficiently strong rationale for immediate initiation of treatment in the postoperative period. A considered approach involving colonoscopy in the first six to 12 months is likely to be beneficial in this group."