Author(s): Mehmet Rami Helvaci*, Yasemin Kayabasi, Ozlem Celik, Guner Dede, Abdulrazak Abyad and Lesley Pocock
Background: Smoking may cause a low-grade inflammation on vascular endothelium terminating with an accelerated atherosclerosis-induced end-organ insufficiencies. Plasma triglycerides may be positive acute phase reactants (APRs) whereas fasting plasma glucose (FPG) negative APR indicating the inflammatory effects of smoking.
Method: Consecutive patients with irritable bowel syndrome (IBS) and age and sex-matched control cases were included. IBS was diagnosed according to Rome II criteria in the absence of red flag symptoms including pain, nocturnal diarrhea, weight loss, fever, or any abnormal finding of the physical examination.
Results: The study included 936 patients with IBS (592 females) and 346 control cases. Mean age of the patients was 41.0 years, and 63.2% of them were female. Prevalence of smoking was higher in the patients, significantly (35.2% versus 20.8%, p<0.001). Prevalences of chronic gastritis (80.4% versus 15.0), antidepressants use (46.4% versus 16.1%), hemorrhoids (37.1% versus 7.2%), and urolithiasis (22.0% versus 9.5%) were also higher in them, significantly (p<0.001 for all). Beside that mean values of FPG (111.9 versus 105.4 mg/dL, p= 0.002) and plasma triglycerides (167.0 versus 147.3 mg/dL, p= 0.013) were higher in the IBS cases, again.
Conclusion: IBS may be a low-grade inflammatory process initiated with anxiety, depression, smoking, infection, inflammation, and cancer fearlike stresses, and eventually terminates with dysfunctions of gastrointestinal and genitourinary tracts. Because plasma triglycerides are well-known APRs, the additionally increased FPG in the IBS cases may show the fact that FPG may initially behave as a positive but eventually negative APR as in the smokers in the body.
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