Skip to main content
PMC home page
Annals of The Royal College of Surgeons of England logoLink to Annals of The Royal College of Surgeons of England
. 1996 Mar;78(2):85–91.

Colonic mucus, smoking and ulcerative colitis.

R D Pullan 1
PMCID: PMC2502541  PMID: 8678464

Abstract

Human colonic mucosal protection is not fully understood but may in part rely on a layer of mucus gel adherent to the mucosa. Ulcerative colitis may occur if mucosal protection breaks down. Two studies are presented, both of which relate to the aetiology of ulcerative colitis. First, a layer of adherent mucus gel was demonstrated by a simple, reliable method. Measurements of mucus layer thickness were made in freshly resected colonic specimens and shown to increase from a mean of 107 microns on the right colon to 155 microns in the rectum. In ulcerative colitis the layer is significantly thinner or absent, whereas in Crohn's disease the colonic mucus layer is significantly thicker. Second, the relationship between smoking and colitis is explored by a double-blind, randomised and placebo-controlled trial of transdermal nicotine in active disease. Significant clinical benefit was seen, indicating nicotine may be both useful therapeutically and the component of tobacco smoke that acts to protect against colitis. Since smoking and nicotine have actions on mucosae and mucus in other organs, it is argued that there is a mucus deficiency in ulcerative colitis that smoking acts to reverse.

Full text

PDF
85

Images in this article

86Figure 2
on p.86
87Figure 3
on p.87

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Calkins B. M. A meta-analysis of the role of smoking in inflammatory bowel disease. Dig Dis Sci. 1989 Dec;34(12):1841–1854. doi: 10.1007/BF01536701. [DOI] [PubMed] [Google Scholar]
  2. Cope G. F., Heatley R. V., Kelleher J. K. Smoking and colonic mucus in ulcerative colitis. Br Med J (Clin Res Ed) 1986 Aug 23;293(6545):481–481. doi: 10.1136/bmj.293.6545.481. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Harries A. D., Baird A., Rhodes J. Non-smoking: a feature of ulcerative colitis. Br Med J (Clin Res Ed) 1982 Mar 6;284(6317):706–706. doi: 10.1136/bmj.284.6317.706. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Kerss S., Allen A., Garner A. A simple method for measuring thickness of the mucus gel layer adherent to rat, frog and human gastric mucosa: influence of feeding, prostaglandin, N-acetylcysteine and other agents. Clin Sci (Lond) 1982 Aug;63(2):187–195. doi: 10.1042/cs0630187. [DOI] [PubMed] [Google Scholar]
  5. Kollerstrom N., Lord P. W., Whimster W. F. A difference in the composition of bronchial mucus between smokers and non-smokers. Thorax. 1977 Apr;32(2):155–159. doi: 10.1136/thx.32.2.155. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Lang M., Hümmer B., Hahn H. L. Effect of systemic nicotine on mucus secretion from tracheal submucosal glands and on cardiovascular, pulmonary, and hematologic variables. Klin Wochenschr. 1988;66 (Suppl 11):170–179. [PubMed] [Google Scholar]
  7. Motley R. J., Rhodes J., Ford G. A., Wilkinson S. P., Chesner I. M., Asquith P., Hellier M. D., Mayberry J. F. Time relationships between cessation of smoking and onset of ulcerative colitis. Digestion. 1987;37(2):125–127. doi: 10.1159/000199478. [DOI] [PubMed] [Google Scholar]
  8. Motley R. J., Rhodes J., Williams G., Tavares I. A., Bennett A. Smoking, eicosanoids and ulcerative colitis. J Pharm Pharmacol. 1990 Apr;42(4):288–289. doi: 10.1111/j.2042-7158.1990.tb05411.x. [DOI] [PubMed] [Google Scholar]
  9. Pullan R. D., Ganesh S., Mani V., Morris J., Evans B. K., Williams G. T., Rhodes J. Comparison of bismuth citrate and 5-aminosalicylic acid enemas in distal ulcerative colitis: a controlled trial. Gut. 1993 May;34(5):676–679. doi: 10.1136/gut.34.5.676. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Pullan R. D., Rhodes J., Ganesh S., Mani V., Morris J. S., Williams G. T., Newcombe R. G., Russell M. A., Feyerabend C., Thomas G. A. Transdermal nicotine for active ulcerative colitis. N Engl J Med. 1994 Mar 24;330(12):811–815. doi: 10.1056/NEJM199403243301202. [DOI] [PubMed] [Google Scholar]
  11. Pullan R. D., Thomas G. A., Rhodes M., Newcombe R. G., Williams G. T., Allen A., Rhodes J. Thickness of adherent mucus gel on colonic mucosa in humans and its relevance to colitis. Gut. 1994 Mar;35(3):353–359. doi: 10.1136/gut.35.3.353. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Rhodes J. M. Colonic mucus and mucosal glycoproteins: the key to colitis and cancer? Gut. 1989 Dec;30(12):1660–1666. doi: 10.1136/gut.30.12.1660. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Srivastava E. D., Russell M. A., Feyerabend C., Rhodes J. Effect of ulcerative colitis and smoking on rectal blood flow. Gut. 1990 Sep;31(9):1021–1024. doi: 10.1136/gut.31.9.1021. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Thomas G. A., Rhodes J., Mani V., Williams G. T., Newcombe R. G., Russell M. A., Feyerabend C. Transdermal nicotine as maintenance therapy for ulcerative colitis. N Engl J Med. 1995 Apr 13;332(15):988–992. doi: 10.1056/NEJM199504133321503. [DOI] [PubMed] [Google Scholar]
  15. Zijlstra F. J., Srivastava E. D., Rhodes M., van Dijk A. P., Fogg F., Samson H. J., Copeman M., Russell M. A., Feyerabend C., Williams G. T. Effect of nicotine on rectal mucus and mucosal eicosanoids. Gut. 1994 Feb;35(2):247–251. doi: 10.1136/gut.35.2.247. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Annals of The Royal College of Surgeons of England are provided here courtesy of The Royal College of Surgeons of England

RESOURCES