Role of smoking in functional dyspepsia and irritable bowel syndrome : three random population-based studies
Talley, Nicholas J.; Powell, Nicholas; Walker, Marjorie M; Jones, Mike P.; Ronkainen, Jukka; Forsberg, Anna; Kjellström, Lars; Hellström, Per M.; Aro, Pertti; Wallner, Bengt; Agréus, Lars; Andreasson, Anna (2021-05-13)
Talley, NJ, Powell, N, Walker, MM, et al. Role of smoking in functional dyspepsia and irritable bowel syndrome: three random population-based studies. Aliment Pharmacol Ther. 2021; 54: 32– 42. https://doi.org/10.1111/apt.16372
© 2021 John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Talley, NJ, Powell, N, Walker, MM, et al. Role of smoking in functional dyspepsia and irritable bowel syndrome: three random population-based studies. Aliment Pharmacol Ther. 2021; 54: 32– 42, which has been published in final form at https://doi.org/10.1111/apt.16372. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
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https://urn.fi/URN:NBN:fi-fe2022020317560
Tiivistelmä
Abstract
Background: It is uncertain if functional dyspepsia (FD) or irritable bowel syndrome (IBS) are linked to smoking, and smoking cessation is not part of the routine advice provided to these patients.
Aim: To assess if smoking is an independent risk factor for FD and IBS.
Methods: Three population-based endoscopy studies in Sweden with 2560 community individuals in total (mean age 51.5 years, 46% male). IBS (14.9%), FD (33.5%), and associated symptoms were assessed using the validated abdominal symptom questionnaire, and smoking (17.9%) was obtained from standardised questions during a clinic visit. The effect of smoking on symptom status was analysed in an individual person data meta-analysis using mixed effect logistic regression, adjusted for snuffing, age and sex.
Results: Individuals smoking cigarettes reported significantly higher odds of postprandial distress syndrome (FD-PDS) (OR 10–19 cig/day = 1.42, 95% CI 1.04–1.98 P = 0.027, OR ≥20 cig/day = 2.16, 95% CI 1.38–3.38, P = 0.001) but not epigastric pain. Individuals smoking 20 or more cigarettes per day reported significantly higher odds of IBS-diarrhoea (OR = 2.40, 95% CI 1.12–5.16, P = 0.025), diarrhoea (OR = 2.01, 95%CI 1.28–3.16, P = 0.003), urgency (OR = 2.21, 95%CI 1.41–3.47, P = 0.001) and flatus (OR = 1.77, 95%CI 1.14–2.76, P = 0.012) than non-smokers. Smoking was not associated with IBS-constipation or IBS-mixed.
Conclusions: Smoking is an important environmental risk factor for postprandial distress syndrome, the most common FD subgroup, with over a twofold increased odds of PDS in heavy smokers. The role of smoking in IBS-diarrhoea, but not constipation, is also likely important.
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