Sigara kullanımının ülseratif kolitte total rektum duvar kalınlığı üzerine etkisi olabilir mi?

Yıl 2020, , 73 - 76, 30.12.2020

İbrahim Köker Hilal Köker Gülbin Ünsal Ahmet Tezel Hasan Ümit Ali Soylu

https://doi.org/10.17940/endoskopi.832000

Öz

Giriş ve Amaç: Ülseratif kolit idiyopatik, relapslarla seyreden kronik inflamatuvar bir hastalıktır. Sigara kullanımı ülseratif kolit gelişiminde ve progresyonunda etkilidir. Amacımız sigara kullanım öyküsü olan ülseratif kolitlilerde total rektal duvar kalınlığını değerlendirmekti. Gereç ve Yöntem: Çalışmaya 19 ülseratif kolitli hasta ve 19 kişilik kontrol gurubu alındı. Transrektal ultrasonografi ile total rektal duvar kalınlığı, ülseratif kolit gurubu ile kontrol gurubu arasında karşılaştırıldı. Ülseratif kolit gurubunda total rektal duvar kalınlığını belirgin olarak artmış saptadık. Daha sonra ülseratif kolit ve kontrol gurupları içinde total rektal duvar kalınlığını sigara içme öyküsü olanlarla olmayanlar arasında karşılaştırdık. Bulgular: Çalışmamıza 19 ülseratif kolit li hasta (4 kadın/15 erkek, ortalama yaş 46.8±13.3) ve 19 kontrol (5 kadın/14 erkek, 46.6±11.8) alındı. Ülseratif kolitlilerin 9’unda hastalık aktifken, 10’u remisyondaydı. Total rektal duvar kalınlığını ülseratif kolit’lilerde kontrollere göre artmış olarak saptadık, median sırasıyla [4.1 mm (3.1-4.6)]’ye karşın [2.5 mm (2.0-3.7)] (P=0.003). Ek olarak, total rektal duvar kalınlığı sigara öyküsü olan ülseratif kolit hastalarında sigara öyküsü olmayanlara göre belirgin olarak arttığını saptadık, sırasıyla median [4.6 mm (4.3-4.9)]’ye karşın [3.8 mm (2.6-4.1)] (P=0.025). Kontrol gurubunda ise sigara kullanım öyküsüne göre total rektal duvar kalınlığında farklılık yoktu. Sonuç: Sigara kullanım öyküsü olan ülseratif kolitlilerde transrektal ultrasonografi ile total rektal duvar kalınlığını artmış olarak saptadık.

Anahtar Kelimeler

Transrektal ultrasonografi, ülseratif kolit

Can smoking have an effect on total rectum wall thickness in ulcerative colitis?

Öz

Background and Aims: Ulcerative colitis is an idiopathic, chronic inflammatory disease with a high relapse rate. Smoking contributes to the development and progression of ulcerative colitis. We determined total rectal wall thickness in patients with ulcerative colitis who had a smoking history. Materials and Methods: We included 19 patients with ulcerative colitis (ulcerative colitis group) and 19 controls (control group) and compared total rectal wall thickness among them. Total rectal wall thickness was significantly greater in the ulcerative colitis group. We also compared total rectal wall thickness between patients with and without smoking history in both groups. Results: Of the 19 patients with ulcerative colitis, 4 and 15 were females and males, respectively, with a mean age of 46.8±13.3 years. Of the 19 controls, 5 and 14 were females and males, respectively, with a mean age of 46.6±11.8 years. While 9 patients with ulcerative colitis were active, 10 were in remission. The median (interquartile range) total rectal wall thickness was significantly higher in the ulcerative colitis group (4.1 mm [3.1–4.6]) than in the control group (2.5 mm [2.0-3.7]) (p=0.003). The median total rectal wall thickness was significantly higher in patients with ulcerative colitis and a smoking history than in those without (4.6 mm [4.3-4.9] vs. 3.8 mm [2.6-4.1], respectively; p=0.025). Total rectal wall thickness did not differ according to smoking history in the control group. Conclusion: Smoking history is associated with total rectal wall thickness increase patients with ulcerative colitis on transrectal ultrasonography.

Anahtar Kelimeler

Transrectal ultrasonography, ulcerative colitis, cigarette smoking

Kaynakça

• 1. Zhai H, Huang W, Liu A, et al. Current smoking improves ulcerative colitis patients’ disease behaviour in the northwest of China. Prz Gastroenterol 2017;12:286-90.
• 2. Park S, Chun J, Han K, et al. Dose–response relationship between cigarette smoking and risk of ulcerative colitis: a nationwide population-based study. J Gastroenterol 2019;54:881-90.
• 3. Gorrepati VS, Stuart A, Deiling S, et al. Smoking and the risk of pouchitis in ulcerative colitis patients with ileal pouch-anal anastomosis. Inflamm Bowel Dis 2018;24:2027-32.
• 4. Gajendran M, Loganathan P, Jimenez G, et al. A comprehensive review and update on ulcerative colitis. Dis Mon 2019;65:100851.
• 5. Deepak P, Bruining DH. Radiographical evaluation of ulcerative colitis. Gastroenterol Rep 2014;2:169-77.
• 6. Rasmussen SN, Riis P. Rectal wall thickness measured by ultrasound in chronic inflammatory diseases of the colon. Scand J Gastroenterol 1985;20:109-14.
• 7. Dağlı U, Över H, Tezel A, Ülker A, Temuçin G. Transrectal ultrasound in the diagnosis and management of inflammatory bowel disease. Endoscopy 1999;31:152-7.
• 8. Baron JH, Connell AM, Lennard-Jones JE. Variation between observers in describing mucosal appearances in proctocolitis. Br Med J 1964;1:89-92.
• 9. Ruess L, Blask AR, Bulas DI, et al. Inflammatory bowel disease in children and young adults correlation of sonographic and clinical parameters during treatment. AJR Am J Roentgenol 2000;175:79-84.
• 10. Dubbins PA. Ultrasound demonstration of bowel wall thickness in inflammatory bowel disease. Clin Radiol 1984;35:227-31.
• 11. Worlicek H. Sonography of the small and large intestine--differential diagnosis of wall thickening. Bildgebung 1988;56:27-34.
• 12. Flesisher AC, Muhletaler CA, James AE. Sonographic patterns arising from normal and abnormal bowel. Radiol Clin North Am 1980;18:145-59.
• 13. Hurlstone DP, Sanders DS, Lobo AJ, McAlindon ME, Cross SS. Prospective evaluation of high-frequency mini-probe ultrasound colonoscopic imaging in ulcerative colitis: A valid tool for predicting clinical severity. Eur J Gastroenterol Hepatol 2005;17:1325-31.
• 14. Ellrichmann M, Wietzke-Braun P, Dhar S, et al. Endoscopic ultrasound of the colon for the differentiation of Crohn’s disease and ulcerative colitis in comparison with healthy controls. Aliment Pharmacol Ther 2014;39:823-33.
• 15. Shimizu S, Tada M, Kawai K. Endoscopic Ultrasonography in Inflammatory Bowel Diseases. Gastrointest Endosc Clin N Am 1995;5:851-9.
• 16. Higaki S, Nohara H, Saitoh Y, et al. Increased rectal wall thickness may predict relapse in ulcerative colitis: A pilot follow-up study by ultrasonographic colonoscopy. Endoscopy 2002;34:212-9.
• 17. Gast P, Belaiche J. Rectal endosonography in inflammatory bowel disease: Differential diagnosis and prediction of remission. Endoscopy 1999;31:158-66.
• 18. Rustemovic N, Cukovic-Cavka S, Brinar M, et al. A pilot study of transrectal endoscopic ultrasound elastography in inflammatory bowel disease. A pilot study of transrectal endoscopic ultrasound elastography in inflammatory bowel disease. BMC Gastroenterol. 2011;11:113.
• 19. Arda K, Çetinkaya H, Dağlı Ü. İnflamatuvar Barsak Hastalıkları El Kitabı. Ankara: İnflamatuvar Barsak Hastalıkları Derneği, 2006:5-34.
• 20. Freidman S, Blumberg RS. Inflammatory bowel disease. Fauci AS, Kasper DL, Longo DL, Braunwald E, Hauser Sl, Jameson JL, Loscalzo J (Eds.). Harrison’s Principles of Internal Medicine. 17th ed. New York: Mc Graw Hill Co; 2008.1886-909.