Smoking And The GI Tract | Cary… | Cary Gastroenterology Associates

Smoking damage is not limited to the respiratory system. It actually affects the entire body including the digestive tract. Diet, nutrition, and exercise play key roles in keeping the digestive system healthy and smoking can counteract all of them. If you smoke, it is never too late to quit. Smoking affects many areas of the GI tract that you may not have anticipated.


There are several cancers that have been found to be increased by smoking. These include cancers of the mouth, esophagus, stomach, and pancreas. Researchers are also suggesting that cancer of the liver, colon, and rectum, may also be linked to smoking.

Heartburn and GERD

Smoking weakens the lower esophageal sphincter, a small muscle at the base of the esophagus that opens to allow food to enter the stomach and then closes again. When the LES fails to close completely acid from the stomach reenters the esophagus causing the telltale pain and burning of heartburn and GERD.

Peptic Ulcers

Smoking has been linked to the increase in peptic ulcers. Researchers are studying just exactly how the link works, but current thinking suggests that tobacco use increases the risk of H. pylori infections and also decrease blood flow to the stomach lining. As research continues, a better understanding will come as to how smoking increases the production of pepsin, an enzyme that breaks down protein but can also damage the stomach lining when over produced.

Liver Disease

There are two diseases of the liver that may be worsened by smoking: PBC and NAFLD. Primary biliary cirrhosis is a chronic disease that slowly damages the bile ducts found in the liver. Nonalcoholic fatty liver disease (NAFLD) is a fat build up in the liver that can, over time, cause scarring similar to cirrhosis found in the liver of those who abuse alcohol.

Crohn’s Disease

Crohn’s disease is a chronic, inflammatory disease of the digestive tract. Current and former smokers are at greater risk than those who have never smoked to develop Crohn’s. Patients with Crohn’s who smoke are more likely to have severe symptoms, more complications, require more medications, and require more surgeries than patients who do not smoke. Smoking affects women with Crohn’s more negatively than male patients who smoke.

Colon Polyps

Polyps are small growths on the lining of the colon. Polyps can be benign, precancerous, or cancerous. Smokers have more polyps, larger polyps, and a greater chance of recurrence than those who do not smoke.


Pancreatitis is an inflammation of the pancreas. The inflammation causes the normal enzymes found in the organ to damage the organ itself. Pancreatitis can be severe, even life-threatening. Smoking increases the risk of developing pancreatitis.


Gallstones are hard particles that develop inside the gallbladder. The function of the gallbladder is to store bile made by the liver. It is linked by an extensive system of ducts that connect it to the liver, pancreas, and small intestine. Gallstones can move into these ducts, blocking the movement of fluids and causing pain, inflammation, and infection. Some research has indicated that there could be a link between smoking and the development of gallstones, the research is not definitive and more study is needed.

If you want to learn more about the effects of smoking on the GI tract and other health risks related to smoking, contact Cary Gastroenterology today.

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