Does Vaping & Smoking Cause IBS?

What is IBS?

Irritable bowel syndrome (IBS) is a digestive disorder that is characterised by a set of gut symptoms. The symptoms of IBS include:

• Bloating
• Abdominal pain (tummy pain)
• Changes in stool frequency or form

With IBS, it is also common for there to be an increase in urgency (how quickly you need to get to the toilet) as we as certain foods that trigger or increase IBS symptoms.

IBS is experienced by approximately 12% of the global population and is the most common digestive issue that is seen by doctors and gastroenterologists.

There is not a single cause of IBS but a collection of factors that may be responsible for the change in the functions of the digestive tract. The underlying issues that can cause IBS include the following:

• Alterations to brain-gut connection
• Post-infectious reactions
• Low-grade gut inflammation
• Low-grade mucosal immune activation
• Changes and imbalances in the gut microbiome (the gut bacteria)
• Dysregulation of serotonin signalling
• Genetic factors

When approaching IBS it’s important to understand the impact of smoking as well as vaping and e-cigarettes have on the gut and the gut microbiome. [Source: Pubmed]

Does smoking cause inflammation in the gut?

Smoking is the leading cause of preventable deaths in the world with conditions such as obstructive pulmonary disease (COPD), cardiovascular disease, and cancers being most prevalent. This is understood to be due to the toxic components in cigarette smoke.

Cigarette smoke is a mixture of compounds that include:

• Nicotine
• Aldehydes
• polycyclic aromatic hydrocarbons (PAHs)
• nitrosamines
• heavy metals (cadmium, lead, arsenic)

Studies have found that the toxic compounds in cigarette smoke can decrease antioxidants in the body (such as vitamin C), increase oxidation as well as increase levels of inflammation in the blood of the smoker.

The toxins from cigarette smoke are also swallowed into the gut. In addition to inflammation, these compounds can also lead to imbalances in the gut microbiome, commonly termed dysbiosis. [Source: Pubmed]

Can nicotine cause IBS?

Nicotine is naturally found in tobacco and in addition to being absorbed through the lungs when smoked, it is also absorbed through the skin and the gut.

Nicotine has been shown to have biological benefits that include:

• increasing metabolic rate
• suppressing appetite
• regulating body weight
• influencing brain function
• alleviating symptoms of Ulcerative Colitis [Source: Pubmed]

There are also detrimental consequences to nicotine use which include negative changes to the gut bacteria.

Nicotine can lead to changes in the gut bacteria which have been associated with IBS symptoms. These changes include:

• Reduction of beneficial bacteria, Bifidobacterium
• Reduction of beneficial short-chain fatty acids (a main energy source for the gut cells)
• Elevated pH in the gut can allow for less beneficial bacteria to grow, leading to dysbiosis.

Dysbiosis (imbalances) in the gut microbiome has been shown to contribute to the development of inflammatory bowel disease (IBD) and is commonly seen in IBS. [Source: Pubmed, Pubmed]

Other compounds in cigarette smoke have also been shown to impact gut health.

Polycyclic Aromatic Hydrocarbons have been shown to lead to imbalances in the gut, increase inflammation and contribute to increased intestinal permeability (leaky gut).

Aldehydes have also been shown to contribute to gut inflammation, imbalances in the gut bacteria as well as suppression of the immune system in the gut which may make it more susceptible to infections. Acetaldehyde can also be fermented by less beneficial gut bacteria which can then lead to a rise in these species. It can also increase the permeability of the gut lining contributing to increased intestinal permeability (leaky gut).

Heavy metals found in tobacco smoke include cadmium, arsenic, lead, chromium, iron, mercury, nickel, and vanadium. Some of the can be transferred to the gut where they contribute to bacterial imbalances. In addition to this, heavy metals have also been shown to contribute to inflammation in the gut lining. [Source: Pubmed]

Is smoking good for IBS?

Tobacco smoking has been shown to increase the risk of cancer and cardiovascular disease. It has also been shown to increase the risk of certain gut conditions.

The gut conditions smoking increases the risk of include:

• Crohn’s disease
• Peptic ulcer disease
• Gastroesophageal reflux disease (GERD)
• Gastric carcinoma (stomach cancer) [Source: Pubmed]

However, it has been reported that smoking may have a protective effect and reduce the risk of other gut conditions.

These include:

• Ulcerative colitis
• IBS [Source: Pubmed]

A 2020 study concluded that IBS was more common in non-smokers than in those who smoked. A second study reported that this may be truer for the female population. E.g.: female non-smokers experienced IBS more commonly than female smokers but there was no difference in the male population between smokers and non-smokers. [Source: Pubmed, Pubmed]

The reasons for this are not fully understood. However, factors may be partly responsible include:

• The stool softening effects of smoking. This can reduce constipation and therefore the IBS symptoms that might come along with it.
• The protective effect of nicotine on the gut lining.

Is vaping bad for IBS?

While seen as a healthier option than smoking, vaping and e-cigarettes have been shown to increase gut inflammation, contribute to bacterial imbalances and lead to an increase in the permeability of the gut lining (leaky gut). [Source: Pubmed]

While nicotine is the addictive component of vaping liquid, the other chemical ingredients are likely what is responsible for the changes in the gut. These chemicals include propylene glycol (PG), glycerol (VG), flavourings, and contaminants.

Studies have also shown that vaping leads to inflammation and immune activation in the respiratory system of users. This may also lead to increased susceptibility to bacterial and viral infections. [Source: BMJ, Pubmed]

Does vaping cause IBS?

While vaping has not been shown to cause IBS, it has been shown to damage the gut in ways commonly seen in IBS. This is through damage to the gut lining, inflammation in the gut, bacterial imbalances and making the gut more susceptible to bacterial and viral infections.

Studies have found that nicotine may not be responsible for these issues. Instead, the other ingredients (These chemicals include propylene glycol (PG), glycerol (VG), flavourings, and contaminants), when heated for toxic compounds. This was reported in a study showing that nicotine-containing and nicotine-free vaping liquids both had the same negative impact. [Source: Pubmed]

The negative effects of vaping and e-cigarettes:

• Gut inflammation
• Increased intestinal permeability
• Imbalances in the oral microbiome (the bacteria in the mouth)
• Gut bacterial imbalances [Source: Pubmed]

Smoking and stomach ulcers

Smoking and nicotine are both associated with the development of ulcers in the digestive tract.

This is understood to happen via several mechanisms:

1. Increasing stomach acid levels
2. Reduction in the protective mucus lining the digestive tract
3. Increasing bile salt reflux rate
4. Increasing gastric bile salt concentration

Not only do smoking and nicotine and nicotine increase the risk of developing an ulcer, but they also increase the ulcer-causing ability of factors that include:

• H. pylori
• Alcohol
• Nonsteroidal anti-inflammatory drugs (NSAIDs)

Smoking and nicotine further worsen all of the above via 2 further mechanisms:

1. They increase the rate at which cells die in the gut, therefore delaying the healing process.
2. They reduce the blood flow to the gut, limiting the supply of nutrients required for healing.

Conclusion

While smoking may slightly reduce the risk of IBS due to the well documental increases in cancers, cardiovascular diseases as well as other digestive issues (Crohn’s disease, peptic ulcer disease, gastroesophageal reflux disease, stomach cancer) it should not be approached as a treatment for IBS.

Emerging research has also shown clear negative effects of vaping and e-cigarettes on gut health. These changes are commonly seen in IBS which means this is not a gut-friendly alternative to smoking tobacco.

Natural approaches to gut health include:

• Dietary support
• Evidence-based supplements (such as probiotics)
• Lifestyle support