If you have Irritable Bowel Syndrome (IBS) your gastrointestinal tract often becomes very sensitive and susceptible to certain triggers, including tobacco. Smoking is likely to cause heartburn and reflux, which are already common in IBS and so are likely to worsen.

Smoking may also damage the oesophageal sphincter, allowing stomach acid to flow upwards and into the oesophagus. Nicotine results in an over-production of stomach acid and decreases the production of sodium bicarbonate, resulting in a significant worsening of certain IBS symptoms.

Smoking can also increase the chances of developing peptic ulcers and the chance of ulcers perforating goes up by as much as 10 times. If you suffer from IBS and are a smoker we would recommend trying to cut down and keeping a diary of your IBS outbreaks.

We understand that quitting is hard but if you are able to see how it is worsening your IBS it might prove easier to cut down. Even if you struggle to quit completely reducing the amount you smoke will still help.

Smoking and Inflammatory Bowels Disease (IBD) Crohn’s Disease

The relationship between smoking and Inflammatory Bowel Diseases is a complex one.

Smoking has been shown to increase the risk of Crohn’s disease and may worsen the condition. People with Crohn’s who smoke tend to have more flare-ups and their symptoms can be more severe. They are also at risk of more complications, such as narrowing of the bowel which can be dangerous. Fistulas are also a greater risk for smokers with Crohn’s disease.

Need some motivation to cut down or quit?

If you give up smoking, after a year your chances of a flare-up are the same as someone with Crohn’s who has never smoked. Your risk of surgery also decreases if you quit as does the chance of the disease recurring after surgery.

Ulcerative Colitis

The impact of smoking on ulcerative colitis is more mixed. Surprisingly, research has shown that smokers are less likely to develop the condition than non-smokers. Some people who give up smoking go on to develop ulcerative colitis.

Scientists are unclear why this is but they believe that nicotine may be responsible. People with ulcerative colitis often have a thinner mucus layer in the colon and rectum compared to healthy people. The presence of nicotine in the body may serve to increase the production of this mucus. Nicotine may also suppress the immune system and prevent inflammation in the colon. Some researchers believe that nitric oxide, which is released by nicotine, may reduce the activity of muscles in the colon, helping to relieve the urgent need to go to the toilet. Smoking can also change the way a person’s genes are expressed and because ulcerative colitis has a genetic component, this may help to prevent the development of the disease.

While this may tempt some people into continuing (or even taking up) smoking to help with ulcerative colitis, the risks of smoking remain high. It increases your risk of many different types of cancer, as well as heart disease and chronic bronchitis. Healthcare professionals strongly advise against such drastic action. There is some evidence that nicotine replacement therapy or nicotine patches may help with the management of the disease in some cases but, again, the results are mixed and you should discuss this with a gastrointestinal specialist before choosing. Many studies point to the fact that nicotine is no more effective than conventional drug treatments for inflammatory bowel disease, such as aminosalicylates and steroids.

Smoking introduces carcinogens into the entire body, including the colon which puts you at greater risk of bowel cancer. The more cigarettes smoked the higher the risk to you so even cutting down will have health benefits. Smokers are at a far higher risk of developing polyps (non-cancerous growths in the bowel). These growths can become cancerous if left untreated.