Heather discussed this in a 2004 Newsletter . Be strong and don't pick up that cigarette again.
Smoking and IBS
"I smoke, and I'm wondering if that is having an effect on my IBS?"
Well, you probably already know the answer to this one. Just like alcohol and caffeine, tobacco is a drug that hits extra hard if you have IBS. Tobacco - whether smoked or chewed - is a powerful GI tract stimulant, irritant, and carcinogen. Since people with IBS have unusually sensitive digestive tracts by definition, and we're prone to severe over-reactions of the gut from normal stimuli (like food, or simply waking up in the morning), it's easy to see why tobacco is one of the worst triggers for all IBS symptoms. That's really the least of it, though, as tobacco has far more severe effects on your GI tract than just exacerbating Irritable Bowel Syndrome.
Tobacco has harmful effects on virtually all parts of the digestive system. It can cause heartburn and reflux (two conditions that folks with IBS are already more likely to develop), because smoking weakens the esophageal sphincter, thus allowing acidic stomach contents to flow upward into the lower part of the esophagus. While most ulcers are associated with an infection with Helicobacter pylori bacteria, or irritation from anti-inflammatory medications, smoking doubles your chance of developing an peptic ulcer, and then interferes with its healing and promotes ulcer recurrences. The increase of ulcer perforation from smoking may be as high as 10-fold. Smoking is also thought to increase the risk of Crohn's disease, and to lead to the development of gallstones.
Nicotine, the addictive element (and a poison) in tobacco, can cause a weakening of the lower esophageal sphincter, increase stomach acid production, and decrease pancreatic production of sodium bicarbonate, a substance that neutralizes stomach acid. In addition to the nicotine, cigarette smoke contains over 400 toxins and 43 known carcinogens, all of which are entering your bloodstream and making their way through your digestive tract. Finally, the extra air swallowed during smoking can cause belching, bloating, and gas.
And, of course, smoking is also known to increase the risk of cancer, including cancers of the digestive tract such as colon, bladder, pancreas, kidney and stomach. Long-term cigarette smoking increases the risk of colorectal cancer for two main reasons: inhaled or swallowed tobacco smoke transports carcinogens to the colon, and tobacco use appears to increase colon polyp size. In general, the bigger the polyp, the greater the chance it will become cancerous. Studies indicate that 12% of fatal colorectal cancers may be directly attributable to smoking.
Setting aside the serious disease risks of smoking, for just plain old IBS the effects of tobacco can be immediate and downright violent. Tobacco irritates the lining of the intestines, which can cause diarrhea, intestinal cramping, pain, bloating, and gas. Nicotine can cause nausea and stomach cramps. Smoking also decreases the efficiency of food digestion and metabolism, which can cause altered bowel movements (already a problem for people with IBS) and bloating. Nicotine withdrawal can cause both constipation and diarrhea. So yes, in a nutshell, tobacco can (and almost certainly will) affect your IBS, and not for the better. If you needed yet another reason to quit smoking, now you've got one.
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