Np. Breslin et al., SURGICAL AND SMOKING HISTORY IN INFLAMMATORY BOWEL-DISEASE - A CASE-CONTROL STUDY, Inflammatory bowel diseases, 3(1), 1997, pp. 1-5
An inverse relation between appendectomy and ulcerative colitis and sm
oking and ulcerative colitis has been proposed. Our study examined the
frequency of common surgical interventions and of smoking in 500 pati
ents with inflammatory bowel disease. They comprised 177 patients with
ulcerative colitis, 134 patients with Crohn's disease, and 189 contro
ls matched for age, sex, and socioeconomic group. Subjects were questi
oned on all previous surgery and on smoking history. The appendectomy
rate among controls was 17.5% (33 of 189), which was significantly gre
ater than that of patients with ulcerative colitis: 8.5% (15 of 177; p
< 0.05). However, after using multiple variable logistic regression a
nalysis, this was no longer statistically significant. There was no si
gnificant difference in appendectomy rate between patients with Crohn'
s disease and controls. The three groups had comparable rates of tonsi
llectomy and cholecystectomy. Of patients with ulcerative colitis, 84.
2% were nonsmokers at the time of diagnosis in contrast to 50.4% among
the patients with Crohn's disease (p < 0.01). In this case-control st
udy, by using multivariate logistic regression analysis, appendectomy
offers no significant protection from developing ulcerative colitis or
Crohn's disease. Smoking appears to be deleterious in Crohn's disease
, whereas a cessation of smoking precedes the onset of ulcerative coli
tis in a significant number of cases.