title: Smoking is associated with several functional gastrointestinal symptoms.
abstract: BACKGROUND
  The etiology behind functional gastrointestinal symptoms is not clear. Only a few studies have examined how lifestyle factors affect these symptoms, especially in middle-aged or elder subjects. The aim of the present study was to describe the prevalence of functional gastrointestinal symptoms in a Swedish population-based cohort of middle-aged to elder subjects, and to examine associations between symptoms and smoking and alcohol use.
  
  
  METHODS
  This study was conducted on a web-based baseline questionnaire from a part of the EpiHealth study. The cohort included 16,840 subjects between 45 and 75 years of age. Subjects with organic gastrointestinal diseases were excluded. Gastrointestinal symptoms were defined as functional abdominal pain, functional bloating, functional constipation, and functional diarrhea. Parameters regarding age, gender, educational level, occupation, civil status, physical activity, and body mass index (BMI) were described, and association between smoking and alcohol habits were calculated, adjusted for parameters with >5 percentage difference between cases and controls.
  
  
  RESULTS
  An association was found between former and current smoking and functional abdominal pain (OR: 1.15, 95% CI: 1.03-1.28 vs. OR: 1.30, 95% CI: 1.08-1.57). Former smoking was associated with functional bloating (OR: 1.18, 95% CI: 1.04-1.33) and functional constipation (OR: 1.28, 95% CI: 1.06-1.56). There was a trend of decreased functional abdominal pain, functional constipation, and functional diarrhea in subjects with a moderate alcohol intake.
  
  
  CONCLUSIONS
  Smoking is associated with functional abdominal pain, functional bloating, and functional constipation. A moderate alcohol intake tends to be associated with decreased risk of functional gastrointestinal symptoms.
authors.affiliation: a Department of Internal Medicine , Lund University, Skane University Hospital , Malmö , Sweden ;
authors.forename: Olof
authors.initials: O
authors.lastname: Lundström
authors.affiliation: b Department of Plastic Surgery , Lund University, Skane University Hospital , Malmö , Sweden.
authors.forename: Jonas
authors.initials: J
authors.lastname: Manjer
authors.affiliation: a Department of Internal Medicine , Lund University, Skane University Hospital , Malmö , Sweden ;
authors.forename: Bodil
authors.initials: B
authors.lastname: Ohlsson
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects / Q000503:physiopathology; D015331:Cohort Studies; D003248:Constipation / Q000209:etiology*; D003967:Diarrhea / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000503:physiopathology*; D011795:Surveys and Questionnaires
keywords: Alcohol; functional gastrointestinal symptoms; smoking