Nicotine therapy to Counter Ulcerative Colitis Flare

Digestive health
1

I am a 32 year male ex-smoker with mild to moderate left sided Ulceraive Colitis, diagnosed 3 years ago. I gave up smoking a while before symptoms appeared.

I've recently gone into a flare, and did some reading about the different options out there. I stumbled across a forum discussing nicotine and Ulcerative Colitis, and decided to give it a go!

I've also decided to share my progress, and see how others have got on with this idea.

Let me know what your experiences have been, and I'll keep giving updates as I go!

2

A bit about my disease so far:

I was diagnosed in 2013 following colonoscopy with moderately severe left sided UC, and prescribed Mesalazine in the form of 2g Salofalk Enema nightly, and 2g oral Pentassa each day.

This took the edge of the symptoms, but was never in true remission, and had ups and downs in terms of symptoms. The most difficult symptom to cope with is the Urgency at times, sometimes brought on by invisible anxiety like trying to find a parking space, or waiting for people to answer the door at a party!

In 2015 I had a Flexible Sigmoidoscopy which found mildy active left sided UC.

The Doc said that he wanted to try and achieve remission by prescribing Prednisolone 30mg daily for two weeks then into a taper. This seemed to spark a pretty harsh flare up, which required two bouts of hospitalisation, and IV Hydrocortisone, discharged with prednisolone on a taper again.

I eventually got back to where I was before the Flexi, but again not into complete remission.

I really didn't get on with the Pred, it seemed to make symptoms worse initially, and the usual side effects were unpleasant.

About 3 weeks ago My Doc suggested that we reduce the dose of Mesalasine by half, to see if that makes the mild symptoms dissapear (2-3 BM/day, loose stool, no blood, sometimes urgency.)

After a week of this reduced dose, I started to notice symptoms worsening. And then Blood. Here we go, another flare up. I went straight back up to the previous dose of Mesalsine, and started being very carefull what I ate.

Like a said above, a bit of reading led me down this path.

I started on Nicotine patches a week ago.

Day 1.

Applied 15mg patch to my arm in the morning. After a few hours I felt extremely nauseous, and was feeling pretty rubbish with around 10 BM/day. I had to take the patch oof late afternoon, as struggled to cope with the nausea.

Day 2.

I had a funeral to attend, and didn't want to feel like crap so didn't apply the patch, but bought some of the milder 10mg patches to start again tomorrow and increase dose as I get used to it.

Day 3.

Restart. 10mg patch and no real side effects.

I used this lower patch for a couple of days and then went back up to 15mg until now.

After 8 days now I haven't seen much of a difference in symptoms.

I've had better days and bad days, but I intend to push on with it, rasing to the higher dose of 25mg patch in the next couple of days.

That brings you up to date.

3

I've read that nicotine alone doesn't have much effect and it's a combination of different chemicals in ciggies. I have tried gum, Patches and E-Ciggies none really had any real effect. For me diet (low carb Paleo)has been the only thing that has given me any impovement.

Good luck though and keep up with the updates will be interesting to see how it goes.

4

Thanks Tony, I'm continuing with the mesalasine, and in terms of diet I am only eating soft gut friendly foods, very low fibre, and avoiding foods I know I struggle with when in a flare.

I too have read that, and arsenic being one of the chemicals linked to being useful. I won't ever go back to smoking though of course.

Hopefully I'll see some change, as others have reported, but I'm very aware that everyone is different and might just be throwing my money away!

5

I stopped smoking in Jan 2014 and was using e-ciggs. by June I was diagnosed With UC . Looking back I have had some urgency for 10 years but no blood, pain or mucous. I'm 45 and when he diagnosed me my consultant asked if I had recently stopped smoking, he said I was an unusual age to suddenly develop it and there are links.

I'm pretty well controlled with mezevant and I make a lot of bone broth soup which I feel has stabilised me enough that I have resumed a diet high in fruit and veg with no ill effects but I know everyone is different with this disease. I don't think it is nicotine that helps I personally believe it is probably one of the thousands of other chemicals but there clearly is a link. I haven't started smoking again but I was tempted for a while!

6

Thanks missy,

Can you tell me about bone broth soup?

The main reason I thought I'd go ahead with this was the results of a british medical double blind placebo controlled trial which focussed on UC very similar to mine, in people using meds very similar to mine, and showed wuite good results. I'm just hoping that I am one of the people who it will help, but I will be honest in my findings, and If I think improvement is down to something else, I'll say so.

The only thing I've got to loose is the 45 pounds a month or so the patches will cost me, unless I can twist my Doctor's arm into prescribing them for me!

7

Hi Dan

Bone broth is really simple, you can use any bones, I prefer chicken (left over carcass from roast) put in a pot and cover with cold water, bring to the boil skimming any foam off as you go, when it comes then cover and turn gas down as low as you can and leave for at least 8hrs; longer if you can. Then remove bones. I turn it into a veggie soup but if you are having issues with veg I would suggest seasoning and drinking as a broth, it freezes very well. I have one bowl a day. There is some rationale behind bone broth, the bones excrete similar substance to gelatine which is soothing and calming to the gut, do a Google search and you can read more. As I said and we all know, sadly there is no one fix for us all. When I was first diagnosed I was advised to eat bland low fibre food and in all honesty I just ended up eating junk! Through trial and error I have discovered high carb low GI food causes me the most trouble. I wish you well, you sound like you have been through the mill sad

8

Hi Dan,

​Its been a while since i gave my opinion on this very good website because i did not want to endorse smoking because its not for everybodys good health. I will try to keep this as brief as possible.

​Just like you i packed up smoking and two years later i developed UC. At the time of being diagnosed the consultant asked me if i had recently packed up smoking because there seems to be a link. I gave this no more thought untill my UC got so bad it actually put me out of work. 20 times a day on the loo during the day and 5 times at night. Blood, mucus, messing myself in public and not being able to carry out my duties at work it was absolutely ghastly. So being off work i started to look into the smoking link and it was amazing what i found out on the internet, if you dont believe me google search can smoking cure colitis. So long story short, i first tried the patches, e-cigs etc and it did nothing so i bought a packet of fags and i started smoking again on the 4th of may last year. Well, within 3 days my loo visits were down to 10 per day and i actually slept through the night first time in ages. It took me 6 to 8 weeks of back on the ciggies and my visits were down to 4 to 6 times a day and i got myself back to work. The crunch time decision came to me when my consultant was going to put me on anti-immune drugs or worse than that talking about fitting me up with a bag. I personally could not deal with that so i informed him of my smoking link research and told him im going back on the fags to see what happens. Well he and the UC nurse sat there nodding there heads and looking at each other with smiles on there face. He said to me, and this is incredable, go and start smoking and come back in 8 weeks to see me and we will take it from there. I have now been back at work since July last year and i have not been happier. I have had the odd moment when i HAVE to get to the loo, but other than that i have been fine. I am still taking the meds Sulfasalazine 1000mg and Prednisolone 5mg and dont think its a good idea to completely come off them but weighing up 3 years of meds vs 3 days of ciggies was no contest for me, now this is a bit dramatic but when i was at my lowest, 20 times a day, no sleep at night, no job, Blood, Mucus, cant leave the house because of messing myself and the prospect of having a bag fitted, i thought my life was over.

​Im not proud to be back on the fags, having kicked the the habit for over three and a half years and i know what the long term prospect is for smoking but i just could not live like that anymore. So far i smoke 2 to 3 fags a day and im on the loo 3 times sometime 4 times a day absolute bliss being nornal again.

​Please dont think i am telling you to start smoking because we know how bad it is for us, you have to make up your own mind on where you want go with this horrid desease. Ive made my bed and it looks like a packet of Bensons.

​Good luck Terry.

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Thanks missy, so a bit like a stock broth I guess, makes sense to me! I'll give it a go!

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Thanks for that 2daloo, sounds like youve had a hell of a time with that!! I know what you mean, it is contraversial in some eyes, but the people smoke without a medical motivation!

Ill let you know how it goes.

11

Unfortunaelty, this flare up got so bad that it was taken out of my hands and I had to go onto a course of prednisolone, therefore ruining any chance of measuring the effectiveness of the nicotine therapy. Therfore this brings and end to this attempt, and the only conclusion I can draw is that it doesn't work quickly if it works at all for me!

the most important thing is to get better so i can look after my family and carry on working, so thats what im working on. Ill come back to the nicotine idea another time if the situation allows.

Thanks for your help and interest guys!

12

Sorry to hear that. Hope your flare settles down soon.

13

Dan are you on any sort of Biologic.

14

My UC seems direcly linked to smoking.

Every time I gave up smoking over the last 2 years, the UC would start to flare, usually in to the 3rd week when it started getting too bad - bloody and frequent, I would start smoking and then it would start clearing up again after a couple of days with no other meds. Anyway this time around I was determined to give up and try and push through but it hasn't worked and after about 40 days off the cigarrettes I decided to start again as the steroids were not helping. I am seeing a slight improvement but I presume since I have been so long in to this flare it will take a lot of time to reverse out. Am hoping to get this under control, get on immunosuppressants and then hopefully quit smoking again and hopefully taper off the immunosuppressants and hopefully avoid surgery.

I only had flares when I gave up smoking and haven't had a bad flare for 4.5 years.

15

I also was healthy as could be until I quit smoking. Seriously considering picking up a cigarette! This is horrible and takes over my life.