Smoking is recognised as an effective therapy for some patients with conditions in the inflammatory bowel disease group. For example, one treatment regime for patients with Irritable Bowel Syndrome is two cigarettes per day, which is apparently just as effective for some patients as drug therapy.
Ulcerative Colitis normally presents in a patient with one or more close family members who have the condition, and who is a non-smoker. UC belongs to the auto-immune disease group.
Although the cause is not known (apart from the fact that it is almost certainly genetic) and there is no known cure, there are thought to be environmental triggers that cause the patient to develop the symptoms at a given time. Smoking cessation may be one of those causes although there is no accepted proof for any given trigger. It is possible (or probable) that different triggers affect different patients.
There is no proof that nicotine therapy works for a significant number of patients who have already started to show symptoms in UC, although in UC a range of different approaches may be beneficial to different patients. Even dietary therapies cannot be shown to be effective in a significant number of patients, despite the fact that this is a serious chronic bowel condition.
However I found that a family member with long-term UC found benefit from nicotine therapy combined with complete avoidance of tapwater, and drinking / cooking only with bottled water, after a move to an urban area and subsequent worsening of the condition with no other environmental or dietary change showed that drinking water constituents were a significant factor. This was proved by subsequent experimentation.
This patient was able to completely cease all maintenance medication (Salazopyrin) after 25 years of the condition with symptoms that were occasionally severe. The patient subsequently returned to a very low maintenance dosage and symptoms were 99% absent.
As a side issue you might find that avoiding certain types of processed foods is of benefit. You might also consider that the only known way to induce UC in lab rats was found to be ingestion of a type of carrageen (aka carrageenan), a foodstuff emulsifier additive which is still allowed in many countries (E407).
It should be noted by new patients that this is a serious illness that undoubtedly killed a proportion of sufferers before drug therapies were developed to combat it. If untreated the colon ulcers become worse and gangrene results. Even now there is no cure, and side effects seen by some patients include joint degradation (eg hip problems) and eyesight issues such as iritis ('UVitis'). UC patients should ensure that UV400 tinted glasses are worn in very bright sunlight, and if eye surface pain and degraded sight is experienced ('snow blindness'), a doctor is consulted immediately. The fix is simple, just two types of eyedrops.
All you can do is find the drug therapy that suits you. The medicine simply treats the symptoms, there is no cure. You might find that other therapies help but your doctor, rightly, cannot support this approach since there is no proven research that supports this (as far as I am aware). The standard treatment is 4 to 8 500mg Salazopyrin (aka Sulphasalazin) tablets per day, depending on severity of symptoms, and up to 40mg Prednisolone (aka Prednisone) (steroid) in 5mg tablets per day when symptoms are severe (sickness and bleeding). Various other topical therapies are proven effective (eg steroid enema).
My advice is that you ensure that all tablets are of the EC type, enteric coated, as experience shows these are more effective since they deliver in the colon where the problem is, not the upper GI tract. The correct names of the tablets are therefore:
Salazopyrin 500mg EN
Prednisolone 5mg EC
For some reason Salazopyrin enteric coated has a suffix of EN and not EC, which no doctor or pharmacist has ever been able to explain to me. Please note that some doctors less experienced with this condition may initially prescribe non-coated tablets, but this is incorrect.
If the symptoms cannot be stopped or become worse due to drug tolerance (a common occurrence), the only solution is a colostomy of some sort. In younger patients the surgeon, if knowledgable in the procedure, will try to create a Park's Pouch or similar, where the colon is removed and the small intestine then connected to the rectum, with a pouch created by cleverly folding and stitching the last section of the small intestine. This gives a pseudo-normal result, in contrast to a colostomy which involves a front abdominal wall exterior bag which needs emptying. Older patients are less likely to be considered for the pouch type of procedures.
There is an elevated risk of bowel cancer in patients with over 15 years UC. This might be taken into account if symptoms are hard to control after a few years, since a colostomy removes that problem. Not many survive bowel cancer.
This advice was given by an expert patient, not a doctor or pharmacist. You must take professional advice, and wide research of your own is as usual not a bad idea. The fact that avoidance of tap water, and low-dose nicotine therapy, worked for one patient does not mean it will work for you.
