Impact of Smoking on Anal Abscess and Anal Fistula Diseases

Background: Several studies have investigated the association between smoking and anal abscess and anal fistula (AA/F) diseases. However, the relationship between cigarette smoking and AA/F remains unclear. This study sought to assess the role of smoking in anorectal male patients in a Chinese population. Methods: In this retrospective study, a questionnaire, including smoking history, was completed over a 3-month period by male inpatients in the Proctology Department of China-Japan Friendship Hospital. “Cases” were patients who had AA/F, and “controls” were patients with other anorectal complaints. Mann-Whitney U-test and Chi-square test were carried out to examine differences in baseline characteristics between groups. Subsequently, multivariate logistic regression was used to explore any related factors. Results: A total of 977 patients aged from 18 to 80 years were included, excluding those diagnosed with inflammatory bowel disease or diabetes mellitus. Out of this total, 805 patients (82.4%) completed the entire questionnaire. Among the 805 patients, 334 (41.5%) were cases and 471 (58.5%) were controls. Results showed significant differences between cases and controls (&khgr;2 = 205.2, P < 0.001), with smoking found to be associated with the development of AA/F diseases (odds ratio: 12.331, 95% confidence interval: 8.364–18.179, P < 0.001). Conclusions: This study suggested smoking to be a potential risk factor for the development of AA/F diseases in a Chinese population. Consequently, current smoking patients should be informed of this relationship, and further research should be conducted to explore and investigate this further.

[1]  Mark Payne,et al.  Health and Human Services , 2020, Congress and the Nation 2013-2016, Volume XIV: Politics and Policy in the 113th and 114th Congresses.

[2]  S. Signorelli,et al.  Oxidative Stress and Inflammation: Their Role in the Pathogenesis of Peripheral Artery Disease with or Without Type 2 Diabetes Mellitus. , 2017, Current vascular pharmacology.

[3]  M. Ekelund,et al.  Direct and indirect costs for anal fistula in Sweden. , 2016, International journal of surgery.

[4]  D. Sinha,et al.  Methodology of the Global Adult Tobacco Survey — 2008–2010 , 2016, Global health promotion.

[5]  Xueli Yang,et al.  Prevalence of active and passive tobacco smoking among Beijing residents in 2011 , 2016, Chronic diseases and translational medicine.

[6]  Lei Wu,et al.  Additional follow-up telephone counselling and initial smoking relapse: a longitudinal, controlled study , 2016, BMJ Open.

[7]  K. Palipudi,et al.  The Process of Cessation Among Current Tobacco Smokers: A Cross-Sectional Data Analysis From 21 Countries, Global Adult Tobacco Survey, 2009–2013 , 2015, Preventing chronic disease.

[8]  Shenghua Zhou,et al.  Smoking and spontaneous coronary artery dissection: coincidence or not? , 2014, Chinese medical journal.

[9]  Y. Song,et al.  Risk factors for anal fistula: a case–control study , 2014, Techniques in Coloproctology.

[10]  B. Cosman,et al.  Recent Smoking Is a Risk Factor for Anal Abscess and Fistula , 2011, Diseases of the colon and rectum.

[11]  D. Zimmerman.  The impact of smoking on perianal disease. , 2011, Diseases of the colon and rectum.

[12]  H. Abcarian.  Anorectal infection: abscess-fistula. , 2011, Clinics in colon and rectal surgery.

[13]  M. Abbas,et al.  Who Is At Risk for Developing Chronic Anal Fistula or Recurrent Anal Sepsis After Initial Perianal Abscess? , 2009, Diseases of the colon and rectum.

[14]  I. Pascual,et al.  An assessment of the incidence of fistula-in-ano in four countries of the European Union , 2007, International Journal of Colorectal Disease.

[15]  J. Scholefield,et al.  Smoking-related DNA adducts in anal epithelium. , 2004, Mutation research.

[16]  X. Weng,et al.  Beta-carotene protects rats against bronchitis induced by cigarette smoking. , 2003, Chinese medical journal.

[17]  R. Happle,et al.  Cigarette Smoking as a Triggering Factor of Hidradenitis suppurativa , 1999, Dermatology.

[18]  J. Palefsky,et al.  Anal cytological abnormalities and anal HPV infection in men with Centers for Disease Control group IV HIV disease. , 1997, Genitourinary medicine.

[19]  P. Schäfer,et al.  An association of cigarette smoking with recurrent subareolar breast abscess. , 1988, International journal of epidemiology.

[20]  P. Sainio.  Fistula-in-ano in a defined population. Incidence and epidemiological aspects. , 1984, Annales chirurgiae et gynaecologiae.

[21]  H. Abcarian,et al.  A prospective survey of 474 patients with anorectal abscess , 1979, Diseases of the colon and rectum.

[22]  A. Parks.  Pathogenesis and treatment of fistuila-in-ano. , 1961, British medical journal.