Does Smoking Cause Stomach Ulcers?
A common question that many people have concerns the relationship between stomach ulcers and smoking: does smoking causes ulcers? Or, does smoking exacerbate symptoms? Below, you will find the answers to both questions.
Does Smoking Directly Cause Stomach Ulcers?
To answer this simply, the answer is no. It was once thought that lifestyle factors like smoking led to the formation of stomach ulcers, but we now know that the vast majority of ulcers are actually caused by the bacteria H pylori.
The vast minority of ulcers not related to H pylori are caused by the regular or over-usage of non-steroidal anti-inflammatory drugs, also known as NSAIDs. NSAIDs include aspirin, ibuprofen, and naproxen among other drugs (note: acetaminophen is not an NSAID and is main ingredient in Tylenol).
Before the wide-spread acceptance of H pylori as the cause of ulcers, it was thought that smoking, drinking, and a poor diet caused stomach ulcers. The information regarding H pylori has not yet spread to all parts of the globe, and many older individuals do not yet realize that smoking is no longer considered a cause of stomach ulcers. As a result, the idea that smoking is an ulcer cause is still perpetuated despite the fact that it is not true.
However, if you are a smoker, there is some danger in smoking if you have an ulcer, which I will reveal below.
The Smoking and Ulcer Relationship
While ulcers are not caused by smoking, smoking can indeed exacerbate stomach ulcer symptoms through two primary methods: inflammation and stomach acid stimulation.
Cigarette smoke has the effect inflammation on a whole-body level, and the stomach is no exception to this. Chronic smokers may have inflamed stomach tissue, which may increase the severity of symptoms of a pre-existing ulcer.
Additionally, nicotine (the active ingredient in tobacco) has the additional side effect of stimulating the production of stomach acid. This too can heighten stomach ulcer symptoms and make pain worse, as more stomach acid means that the ulcer will get more irritated.
Possible Links Between Smoking and Ulcers
While there is no definitive evidence linking ulcer rates with cigarette smoking, this possibly may be just due to a lack of research.
For example, an older study found that those who smoked had a much higher rate of getting a recurrent ulcer (1). It does not seem that this study was followed up with enough research to make a suggestion either way.
Additionally, a review from 2003 and a new study from 2009 both reported that smoking may change the concentrations of certain enzymes to levels that are conducive to ulceration (2, 3). Smoking definitely has the potential to interfere with ulcer healing (2).
It is unclear whether cigarette smoking may progress the rate at which an untreated ulcer develops, but there is strong evidence that smoking may slow down ulcer healing rates (2).
Despite the studies which are hinting that smoking may indeed influence whether or not a person develops an ulcer, there is just not yet the preponderance of evidence required for this to be widely accepted, nor is their likely to be.
The issue here is not a lack of evidence but rather lack of funding; we already know smoking is extremely harmful to our health and regardless of ulcer status, everyone is urged to quit smoking right away. Linking ulcers to smoking is not likely to change anyone’s mind, as we all already know how harmful smoking can be.
Smoking and Stomach Ulcers Conclusion
As you can see, there is a dichotomy between what is accepted and what is observed through research regarding the relationship between ulcers and smoking.
It does seem that smoking may indeed exacerbate symptoms, act as a secondary factor influencing ulcer formation, and slow ulcer healing, but there is not yet enough evidence to boldly claim that smoking causes ulcers.
References
1. Hull DH, Beale PJ. Cigarette smoking and duodenal ulcer. Gut. 1985 Dec;26(12):1333-7.
2. Maity P, Biswas K, Roy S, Banerjee RK, Bandyopadhyay U. Smoking and the pathogenesis of gastroduodenal ulcer–recent mechanistic update. Mol Cell Biochem. 2003 Nov;253(1-2):329-38.
3. Hammadi M, Adi M, John R, Khoder GA, Karam SM. Dysregulation of gastric H,K-ATPase by cigarette smoke extract. World J Gastroenterol. 2009 Aug 28;15(32):4016-22.
Related posts: