3.12 Gastrointestinal diseases

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3.0 Background

3.1 Tobacco—a leading preventable cause of death and disease

3.2 Cardiovascular diseases

3.3 Lung cancer

3.4 Respiratory diseases

3.5 Other cancers caused by or associated with smoking

3.6 Reproductive health and smoking

3.7 Pregnancy and smoking

3.8 Infant health and smoking

3.9 Increased susceptibility to infection in smokers

3.10 Eye diseases

3.11 Dental diseases

3.12 Gastrointestinal diseases

3.13 Bone density and risk of fractures

3.14 Effects of smoking on the skin

3.15 Smoking and complications in medical treatment

3.16 Smoking and diabetes

3.17 Poorer levels of general health

3.18 Smoking, motor vehicle crashes and other injuries

3.19 Burns and fires caused by tobacco use

3.20 Tobacco poisoning

3.21 Health effects for younger smokers

3.22 Genetic influences on tobacco-caused disease

3.23 Smoking, dementia and cognitive decline

3.24 Lung disease, smoking and occupational exposures

3.25 Air pollution, cigarette smoking and ill health

3.26 Health effects of smoking brands that claim to deliver lower levels of tar, nicotine and carbon monoxide

3.27 Health effects of smoking tobacco in other forms

3.28 Health 'benefits' of smoking?

3.29 Morbidity (ill health) attributable to tobacco-caused disease

3.30 Deaths attributable to tobacco by disease category

3.31 Morbidity and mortality due to tobacco-caused disease and socioeconomic disadvantage

3.32 Health effects of smoking other substances

3.33 Health effects of chewing tobacco, and of other smokeless tobacco products

3.34 Public perceptions of tobacco as a drug, and knowledge and beliefs about the health consequences of smoking

3.35 Health benefits of cessation

3.36 The global tobacco pandemic

Acknowledgments

References

3.12.1 Peptic ulcer disease

Peptic ulcer disease results from the formation of ulcers in the lining of the stomach (gastric ulcers) or duodenum, the section of the small intestine closest to the stomach (duodenal ulcers). A healthy gastrointestinal tract is lined with mucus and other secretions which protect it from damage from gastric acid. If these protective mechanisms are impaired or if there is an increase in gastric acid or other damaging factors, then ulceration may occur. The presence of the gastric bacterium Helicobacter pylori, which causes infection and damage to the gastrointestinal wall, greatly increases the risk of developing peptic ulcer and is present in all sufferers of duodenal ulcers and 70?90% of individuals with gastric ulcers. The risk of development of peptic ulcers is also increased among people who take non-steroidal anti-inflammatory drugs (NSAIDS).5

Smoking also affects the gastrointestinal tract in a number of ways, including by reducing the production of gastric mucus and other protective secretions, promoting duodenal reflux, and reducing blood flow to the lining of the tract. In this compromised environment, the Helicobacter pylori infection is better able to spread and cause damage.5 Smoking may also be related to an increased risk of developing complications of peptic ulcer disease, such as ulcer perforation or bleeding, but this effect may occur only among individuals who are not taking NSAIDS.5

The main effects of smoking on the gastrointestinal tract appear to be short term, the tract recovering following smoking cessation.5

3.12.2 Crohn's disease

Crohn's disease is an inflammatory disease of the digestive tract, most often affecting the small intestine. There is no known cure for Crohn's disease, although drug therapy and surgery may ameliorate the symptoms.

Smokers are more likely to develop Crohn's disease. Smokers who develop the disease may experience a greater severity of symptoms, a greater risk of recurrence or relapse, and higher likelihood of requiring repeat surgery. Stopping smoking improves outcomes and is a major component in improving the course of this disease in smokers.66

Among Australians aged 20 and over in 2004?05, up to 24% of deaths due to Crohn's disease in men, and as many as 38% of deaths in women, could be attributable to tobacco use.7