Did You Know? Smoking Can Affect Your Gut Health Too!

  • 7 minutes, 14 seconds
  • Wellbeing
  • Written by: Dr. Pramod Mane
Smoking Affect Gut Health

Some of us may be regular smokers. Some just go for the occasional smoke. Some do it to look cool in front of their friends, while others do it to escape their stress. Whether you are into smoking or trying to quit, here are some facts for you to digest. Worldwide, more than 7 million deaths per year are caused by tobacco use. If that pattern doesn’t change, more than 8 million people a year will die by 2030. Scared by this statistic? You should be! If you are contemplating on the importance and benefits of stopping smoking, this article is for you.

What harm could a cigarette do anyways?

The effect of smoking is not confined to the lungs, it affects the whole body. It aggravates the risk of many life-threatening diseases including lung cancer and heart disease. Long-term smoking can have serious effects on a person’s immunity, metabolism, and cellular and organ functions. More than 60 carcinogenic and mutagenic compounds are present in cigarette smoke, mostly in the particulate phase. Among all the harmful compounds are some polycyclic aromatic chemical compounds that cause the most damage to our health.

Also, cigarette smoke generates high levels of reactive oxygen and nitrogen species and some devilish chemical compounds like lead and hydrogen cyanide. These compounds can be poisonous and prove to be dangerous to our health even in trace amounts. Cigarette smoke can trigger cancer and more commonly COPD (chronic inflammatory lung disease). These conditions might not show up instantly but the smoke slowly takes a toll on a cellular level causing stress and genetic abruptions making our organs (lungs, heart, liver, kidneys, etc) slightly weaker each passing day.

How smoking affects our digestive system

It is quite understandable that the effect of smoking on the digestive system is not such a well-discussed topic, but it’s high time we understand it.

1. Heartburn and GERD

Smoking can cause severe heartburn leading to GERD (Gastroesophageal reflux disease). Imagine feeling uneasy after a heavy meal and you try to lie down for a while to feel okay, but instead of feeling alright, the acidic contents of your stomach rise upwards causing acid reflux and a burning sensation in your food pipe. This painful condition is called GERD and it can be triggered by smoking. There are a few parts of the body through which smoking can initiate heartburn and GERD:

  • Lower esophageal sphincter – Regular use of tobacco causes a deposit of nicotine in the lower esophageal sphincter, which is the regulator of food passage into the stomach. If the sphincter loosens, there is a significant chance of stomach acid going into the esophagus and damaging it.
  • Salivation – Excessive nicotine inhibits enough salivation. Saliva contains acid-neutralizing bicarbonate which neutralizes the acid damage in the esophagus. Due to low salivation, there is ample chance of acid damage due to refluxed acid
  • Acid secretion in the stomach – Smoking intensifies the stomach acid and triggers excessive production of the acid in the stomach. Hence, for smokers, the risk of acid efflux is much higher than normal people.
  • Muscle relaxation – Nicotine intervenes with the muscle relaxation of the esophagus, which leads to gastric efflux
  • Esophageal lining – Nicotine damages the mucus membranes which protect the esophageal lining, which triggers the gastric efflux

2. Peptic ulcers

Peptic ulcers are a type of sores on the insides of the stomach or duodenum. These sores can flare up with poor eating and drinking habits or even smoking. Smoking increases the risk of H. pylori infection, slows the healing of peptic ulcers, and increases the chance of recurrence of the infection making it an extremely painful condition.

Nicotine in cigarettes have a way of deteriorating GI health

  • Increases gastric-emptying liquids: This causes an increased inflow of digestive juices that cause the food to move too quickly or untimely through the GI tract. This can lead to indigestion, vomiting, diarrhea, or even serious problems like gastroparesis and peptic ulcers.
  • Inhibits pancreatic bicarbonate secretion: Pancreatic bicarbonate is a fluid secreted by the pancreas that aids in digestion by neutralizing the stomach acid and breaking down certain enzymes in our food, it is essential for proper digestion. Smoking can inhibit this action and cause digestive problems.
  • Induces reduction of mucosal blood flow: The inner mucosal lining of the GI tract is a protective lining that prevents any injuries or damage to the GI tract. Smoking often leads to dehydration and reduced blood flow towards the gut, this damages the mucosal lining and makes it more susceptible to ulcers and injuries.
  • Inhibits mucosal prostaglandin production: Mucosal prostaglandins are protectors of the mucosal lining in our GI tract. They can modulate various factors like stomach acid secretions, secretions from other digestive organs ( liver, pancreas), and blood flow towards the gut. Cigarette smoking can inhibit these mucosal prostaglandins and cause an imbalance to gut health.

3. Crohn’s disease

Crohn’s disease is an inflammatory bowel disease that irritates the GI tract along with pain and diarrhea. When a person smokes cigarettes, the good microorganisms in the gut that form the gut microbial flora are wiped out. This affects the gut health severely opening the door to many GI problems like constipation, diarrhea, bloating, indigestion, and so on. Crohn’s disease is one such condition of the GI tract that affects thousands of people around the world. The thing to note here is that Crohn’s disease can become even worse and unmanageable with a smoking habit.

People with Crohn’s who smoke may find that they:

  • have more severe symptoms and complications such as strictures and fistulas
  • have more flare-ups than normal people
  • require more steroids and stronger drugs such as immunosuppressants and biologics to cure.

Some studies even suggest that children and unborn babies exposed to passive smoking may be more likely to develop Crohn’s Disease. Being aware and educated about these facts can help us choose wisely for ourselves and those around us.

4. Gall bladder abnormality

Smoking may prolong the maximal gall bladder emptying time. That is, it may hinder the complete emptying of the gallbladder which may trigger abnormal digestion.

5. Colon polyps

Smoking increases the risk of colon cancer and colon polyps. Although polyps may not always be cancerous, they can develop into cancer. Chronic smokers mostly tend to develop larger and numerous colon polyps. Studies have also confirmed that the risk of developing colon cancer from smoking is as high.

6. Liver disease

Chronic smoking increases the secretion of pro-inflammatory cytokines (IL-1, IL-6, and TNF-α) that trigger liver cell injury. Smoking generates harmful chemicals with oncogenic potential that increases the risk of hepatocellular carcinoma (HCC) in patients with viral hepatitis.

It’s never too late to quit smoking!

Okay, the scary movie is over now. Let’s give you some good news and possibly some motivation. If you quit smoking, some of the adverse effects of smoking on the lungs and digestive system can be reversed. There are several health benefits of quitting smoking over time. Let us elaborate a little:

1. The balance between factors that harm and protect the stomach and duodenum lining returns to normal within a few hours of a person quitting smoking.

2. The liver is responsible for metabolizing the drugs that we take. Smoking can affect how your liver processes these medicines. By quitting smoking, you can avoid or limit the problems of liver disease.

3. People with Crohn’s disease who quit smoking have less severe symptoms than smokers with the disease.

How to quit smoking effectively

You might now be feeling motivated to quit smoking. Here are more tips to help you bring this motivation to fruition.

1. Nicotine Replacement Therapy: Try nicotine replacement therapy like nicotine nasal spray, nicotine patch, nicotine gum, non-nicotine stop-smoking drugs.

2. Stay off common triggers: Avoid the triggers such as the areas you love to smoke in, friends you smoke with, stress, late-night parties, and caffeine. Everyone has their triggers. Try to avoid them by all means.

3. Mind training: Train your mind not to fall for the ‘just one trap. The one can turn into one more, and soon you’ll end up falling off the wagon again.

4. Meditation: Meditation is the best way to take control of your mind and health. Start meditating regularly. It will help you to control the urge to smoke.

5. Physical activity: Engage in physical activity. The more physically active you’ll be, your body will be more able to get away from tobacco cravings and reduce their intensity

6. Seek help: If nothing works out, there are multiple helpline support groups available, who can help you. Consult your doctor if necessary.

To summarise, smoking is extremely injurious to your health, and that includes the digestive system too. So, quit smoking today to reap the benefits of a healthy life!

References –

1. Smoking & Tobacco Use. Available from:https://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm
2. Smoking and the Digestive System. Available from:https://www.niddk.nih.gov/-/media/Files/Digestive-Diseases/Smoking_Digestive_System _508.pdf
3. Smoking and the Digestive System. Available from:https://www.hopkinsmedicine.org/health/conditions-and-diseases/smoking-and-the-digestive system
4. Smoking and the Digestive System. Available from:https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=134&contenti d=177
5. Quit smoking. Available from: https://www.mayoclinic.org/healthy-lifestyle/quit-smoking/in-depth/nicotine-craving/art-20 045454
6. Eastwood GL. The role of smoking in peptic ulcer disease. Journal of clinical gastroenterology. 1988 Jan 1;10:S19-23.
7. Smoking Can Lead to GERD. Available from: https://www.everydayhealth.com/gerd/gerd-and-smoking.aspx
8. How does smoking affect Crohn’s Disease? Available from: http://www.ibdclinic.ca/ibd-and-lifestyle/smoking-and-ibd/smoking-and-crohns-disease/
9. Berkowitz L, et al. Impact of cigarette smoking on the gastrointestinal tract inflammation: opposing effects in Crohn’s disease and ulcerative colitis. Frontiers in immunology. 2018 Jan 30;9:74.
10. Degirmenci B, et al. Acute effect of smoking on gallbladder emptying and refilling in chronic smokers and nonsmokers: A sonographic study. World Journal of Gastroenterology: WJG. 2006 Sep 14;12(34):5540.
11. El-Zayadi A, et al. Heavy smoking and liver. World journal of gastroenterology: WJG. 2006 Oct 14;12(38):6098.
12. Centers for Disease Control and Prevention (US), et al. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention (US); 2010. 5, Cancer.