As the search for the cause of inflammatory bowel disease continues,1 the association between cigarette smoking and a more favorable clinical course in ulcerative colitis remains the sole epidemiologic feature that distinguishes it from Crohn's disease2. Smokers are less likely to have ulcerative colitis, smoking may ameliorate its clinical manifestations, and the onset of colitis is often associated with the cessation of smoking. In contrast, there is an association between cigarette smoking and a less favorable clinical course in Crohn's disease. The enigma eludes a unifying hypothesis. The potential effects of smoking on the gastrointestinal tract include alterations in.
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