SİGARA VE KONSTİPASYON İLİŞKİSİ İNTESTİNAL BİR MİT Mİ ?

Year 2022, Volume: 5 Issue: 2, 89 - 92, 27.06.2022

Emir Avşar , Aynur Türeyen

Abstract

Konstipasyon; uygun olmayan beslenme şekli, yetersiz fiziksel egzersiz, ruhsal problemler, kronik hastalıklar ve kullanılan bazı ilaçlara bağlı olarak gelişebilen, kolonik motilitede azalma ile karakterize bir durumdur. Bireyler konstipasyon şikayetini gidermek için farmakolojik ajanlardan ziyade, alternatif çözümlere daha fazla yönelmektedir. Lifli gıda tüketimi, alt abdomene masaj yapılması, kahvaltı öncesi ılık su içilmesi ya da diyareye sebep olabilecek bazı bitkisel çayların ve takviyelerin kullanılmasının yanı sıra, peristaltizmi arttırdığı düşüncesi ile defekasyon öncesi sigara içmeyi çözüm olarak gören bireylerin sayısı oldukça fazladır. Sigarada bulunan nikotinin, nikotinik reseptörlere bağlanması ile parasempatomimetik sistemi stimüle ederek bağırsak peristaltizmini ve tonusu arttırdığını gösteren çalışmalar mevcuttur. Ancak sigaranın; peptik ülser, pulmoner ve gastrointestinal kanserler, safra kesesi hastalıkları, pankreatit ve kolon polipleri gibi birçok sistemi etkileyen zararlı etkilerinin göz ardı edilerek, bağırsak boşaltımını kolaylaştırıcı etkisinin olduğu düşüncesi ile konstipasyon sürecini yönetmede kullanılması, ciddi sağlık sorunlarına sebep olacaktır. Sigara ve konstipasyon arasındaki ilişkiyi inceleyen çok az sayıda çalışma bulunmaktadır ve bu çalışmalarda IV, sublingual ve transdermal formlarda verilen nikotin ile konstipasyon arasında pozitif korelasyon saptandığı gibi, negatif korelasyonun tespit edildiği raporlar da bulunmaktadır. Bu doğrultuda hemşirelerin; özellikle bireyin sigara konusundaki bilgilerini, tutum ve davranışlarını, alışkanlıklarını ayrıntılı incelemesi ve varsa sigara-konstipasyon ilişkisi konusundaki yanlış inanışlarını düzeltmesi, sigaranın olumsuz etkilerini/zararlarını anlatması, doğru bilgilendirme ve danışmanlık yapması önerilmektedir.

Keywords

konstipasyon, sigara, dışkılama

IS THE RELATIONSHIP BETWEEN SMOKING AND CONSTIPATION AN INTESTINAL MYTH ?

Abstract

Constipation is a condition characterized by a decrease in colonic motility, which may develop due to improper diet, insufficient physical exercise, mental problems, chronic diseases and some drugs used. Individuals turn to alternative solutions rather than pharmacological agents to relieve their constipation complaint. In addition to consuming fibrous food, massaging the lower abdomen, drinking warm water before breakfast or using some herbal teas and supplements that may cause diarrhea, the number of individuals who consider smoking before defecation as a solution, with the thought that it increases peristalsis, is quite high. There are studies showing that nicotine in cigarettes increases intestinal peristalsis and tone by stimulating the parasympathomimetic system by binding to nicotinic receptors. However, smoking; It will cause serious health problems if its harmful effects affecting many systems such as peptic ulcer, pulmonary and gastrointestinal cancers, gallbladder diseases, pancreatitis and colon polyps are ignored and its use in managing the constipation process with the thought of facilitating intestinal emptying. There are very few studies examining the relationship between smoking and constipation, and there are reports of negative correlation as well as positive correlation between constipation and nicotine given in IV, sublingual and transdermal forms. In this direction, nurses; In particular, it is recommended that the individual examines his/her knowledge, attitudes and behaviors, habits in detail about the smoking, corrects his/her misconceptions about the relationship between smoking and constipation, explains the negative effects/harms of smoking, and provides accurate information and counseling.

Keywords

constipation, smoking, defecation

References

• 1. Rao SS, Meduri K. What is necessary to diagnose constipation?. Best practice & research Clinical gastroenterology. 2011;25(1):127-140. doi:10.1016/j.bpg.2010.11.001
• 2. Lagrue G, Cormier S, Mautrait C, Diviné C. Constipation à l’arrêt du tabac. La Presse Médicale. 2006;35(2):246-248. doi:10.1016/S0755-4982(06)74563-8
• 3. Cosnes J, Bourrier A, Nion-Larmurier I, Sokol H, Beaugerie L, Seksik P. Factors affecting outcomes in Crohn's disease over 15 years. Gut. 2012;61(8):1140-1145. doi:10.1136/gutjnl-2011-301971
• 4. Hajek P, Gillison F, McRobbie H. Stopping smoking can cause constipation. Addiction. 2003;98(11):1563-1567. doi:10.1046/j.1360-0443.2003.00497.x
• 5. Baker TB, Breslau N, Covey L, Shiffman S. DSM criteria for tobacco use disorder and tobacco withdrawal: A critique and proposed revisions for DSM‐5. Addiction. 2012;107(2):263-275. doi:10.1111/j.1360-0443.2011.03657.x
• 6. Rausch T, Beglinger C, Alam N, Gyr K, Meier R. Effect of transdermal application of nicotine on colonic transit in healthy nonsmoking volunteers. Neurogastroenterology & Motility. 1998;10(3):263-270. doi:10.1046/j.1365-2982.1998.00105.x
• 7. Talhout R, Schulz T, Florek E, van Benthem J, Wester P, Opperhuizen A. Hazardous compounds in tobacco smoke. Int J Environ Res Public Health. 2011;8:613‐ 628. doi:10.3390/ijerph8020613
• 8. Coulie B, Camilleri M, Bharucha AE, Sandborn WJ, Burton D. Colonic motility in chronic ulcerative proctosigmoiditis and the effects of nicotine on colonic motility in patients and healthy subjects. Alimentary pharmacology & therapeutics. 2001;15(5):653-663. doi:10.1046/j.1365-2036.2001.00959.x
• 9. Meier R. Alters-und geschlechtsspezifische Normwerte der Dickdarmtransitzeit bei Gesunden. Schweiz Med Wschr. 1992;122:940-943.
• 10. Meier R, Beglinger C, Dederding JP, et al. Influence of age, gender, hormonal status and smoking habits on colonic transit time. Neurogastroenterology & Motility. 1995;7(4):235-238. doi:10.1111/j.1365-2982.1995.tb00231.x
• 11. Uysal N, Khorshid L, Eşer İ. Sağlıklı Genç Bireylerde Konstipasyon Sorununun Belirlenmesi. TAF Preventive Medicine Bulletin. 2010;9(2).
• 12. Cummings KM, Giovino G, Jaén CR, Emrich LJ. Reports of smoking withdrawal symptoms over a 21 day period of abstinence. Addictive behaviors. 1985;10(4):373-381. doi:10.1016/0306-4603(85)90034-6
• 13. Stewart RB, Moore MT, Marks RG, Hale WE. Correlates of constipation in an ambulatory elderly population. American Journal of Gastroenterology. 1992;87(7).
• 14. Demol P, Singer MV, Hotz J, Dipp M, Goebell H. Interdigestive gastrointestinal motility and secretion of gastric acid and pancreatic enzymes in young cigarette smokers. Digestion. 1984;29(2):107-111. doi:10.1159/000199018
• 15. Bell J, Go V, Dımagno E. The Effect Of Cıgarette-Smokıng On The Human Interdıgestıve Motor Complex (Idmc). In Clınıcal Research. 1980;28(4):763.
• 16. Sloots CE, Felt-Bersma RJ, West RL, Kuipers EJ. Stimulation of defecation: effects of coffee use and nicotine on rectal tone and visceral sensitivity. Scandinavian journal of gastroenterology. 2005;40(7):808-813. doi:10.1080/00365520510015872
• 17. Murthy KS, McHenry L, Grider JR, Makhlouf GM. Adenosine A1 and A2b receptors coupled to distinct interactive signaling pathways in intestinal muscle cells. Journal of Pharmacology and Experimental Therapeutics. 1995;274(1):300-306.
• 18. Brown SR, Cann PA, Read NW. Effect of coffee on distal colon function. Gut. 1990;31(4):450-453. doi:10.1136/gut.31.4.450
• 19. Lee EJ. Correlations among pain, depressive symptoms, constipation, and serotonin levels in smokers and non smokers. Perspectives in Psychiatric Care. 2020;56(4):864-870. doi:10.1111/ppc.12503
• 20. Kahrilas PJ, Gupta RR. Mechanisms of acid reflux associated with cigarette smoking. Gut. 1990;31(1):4-10. doi:10.1136/gut.31.1.4
• 21. Eastwood GL. The role of smoking in peptic ulcer disease. Journal of clinical gastroenterology. 1988;10:19-23. doi:10.1097/00004836-198812001-00005
• 22. Aune D, Vatten LJ, Boffetta P. Tobacco smoking and the risk of gallbladder disease. European journal of epidemiology. 2016;31(7):643-653. doi:10.1007/s10654-016-0124-z
• 23. Jung HS, Chang Y, Kwon MJ, et al. Smoking and the risk of non-alcoholic fatty liver disease: a cohort study. American Journal of Gastroenterology. 2019;114(3):453-463. doi:10.1038/s41395-018-0283-5
• 24. Barreto SG. How does cigarette smoking cause acute pancreatitis?. Pancreatology. 2016;16(2):157-163. doi:10.1016/j.pan.2015.09.002
• 25. Botteri E, Iodice S, Raimondi S, Maisonneuve P, Lowenfels AB. Cigarette smoking and adenomatous polyps: a meta-analysis. Gastroenterology. 2008;134(2):388-395. doi:10.1053/j.gastro.2007.11.007