Nicotine ulcerative colitis

Transdermal nicotine improved symptoms of patients with mild to moderate active ulcerative colitis in daily doses of 15 to 25 mg. 

Simple antidiarrhoeals are generally contra-indicated, they do not help to reduce mucosal efflux, and may, by reducing colonic transit, predispose to megacolon development. Despite the strong association between non-smoking and the occurrence of ulcerative colitis nicotine patch treatment has shown little evidence of value. 

Nicotine is most often used in replacement therapy for tobacco addiction, but also has some potential uses to treat other conditions. It has been helpful in stopping bleeding in ulcerative colitis. Nicotine gum is being tested in conjunction with Tourette syndrome where it has been seen to lessen the severity and frequency of tics. Nicotine may reduce tremors in Parkinson s patients because it increases dopamine levels, which are reduced in these patients. It also improves attention in Alzheimer s patients. Nicotine is being studied for its effect on dystonias (movement disorders), chronic pain syndrome, sleep apnea, ulcers, attention deficit disorder, obesity, and chronic inflammatory skin disorders as well. 

Smoking aggravates Crohn s disease but (perversely) improves ulcerative colitis. Nicotine patches may provide benefit in ulcerative colitis but the effect is not sufficiently great to justify their routine use in management. 

Nicotine (15-25 mg/day) has also been used to treat active ulcerative colitis. The most common adverse effects were nausea, light-headedness, headache, sleep disturbance, dizziness, and skin irritation (13,14). 

Pullan RD, Rhodes J, Ganesh S, Mani V, Morris JS, Williams GT, Newcombe RG, Russell MA, Feyerabend C, Thomas GA, Sawe U. Transdermal nicotine for active ulcerative colitis. N Engl J Med 1994 330(12) 811-15. 

Nicotine has been proposed as a treatment for ulcerative colitis (but not as a treatment for Crohn s disease) based on the observation of the onset of a flare of ulcerative colitis after smoking cessation in some individuals. When used in the highest tolerated dose, transdermal nicotine improved symptoms of patients with tifild to moderate active ulcerative colitis. ... 

Sandborn WJ, Tremaine WJ, Offord KP, et al. Transdermal nicotine for mildly to moderately active ulcerative colitis. Ann Intern Med 1997 126 364-371. 

Neuronal nAChR subtypes have an active role in neuronal growth, development and plasticity, " and neuronal signal modulation. When nicotine, a nonselective nAChR agonist, is administered, anxiolytic and cytoprotective effects are observed. " High doses of nicotine have been shown to be beneficial to individuals with cognitive and attention deficits, Parkinson s disease, Tourette s syndrome, and ulcerative colitis and... 

---