Effect of smoking on anal sphincter pressure and colonic transit time of constipated patients

Background: Smoking/nicotine protracts transit time in the upper GI tract and small bowel, less is known about the effect on the lower GI tract. Anecdotal reports about the "defecation effect" of the after-breakfast cigarette led us to investigate the effect of smoking on the lower GI tract. Aims: 1. To evaluate the chronic effect of smoking using colonic transit time (CTT). 2. To evaluate the acute effect of smoking using anorectal manometry. Methods: Ten smokers and 10 non-smokers referred because of constipation participated. Following physical examinations, laboratory and endoscopic investigations, idiopathic constipation was the all-inclusive diagnosis. Smokers underwent CTT (Metcalf method) twice the first during smoking period and the second after a 6-days "smoking washout". The non-smoking group had CTr only once. Manometry, using synectics polygraph and waterperfused system, was also performed twice in the smoking group-once at time 0 and then during active smoking. The non-smokers had two anal manometries one at time 0 and the second 20 minutes later, while "sham smoking". Results: