Q. Why do I always feel nauseous after smoking cigarette?

Answered by
Dr. Babu Lal Meena
and medically reviewed by iCliniq medical review team.
Published on Jun 04, 2017 and last reviewed on: Jul 02, 2019

Hi doctor,

I have some major problems with my small intestines. I have cramping pain in my lower abdomen, and I suffer from indigestion, bloating, burping, and nausea. Nausea seems to originate from my lower intestine. If I smoke, it makes me nauseous. I have a constant feeling that something in my lower intestine is irritating. I do not have diarrhea or constipation. I go to the toilet every morning, and the stool looks normal. I feel my appetite has gone down because of all the air in the intestine. I cannot digest fatty foods, milk, and some fruits. I know it is not IBS. If I massage my belly, I get a burning pain in my lower abdomen. I feel like there is some obstruction in my intestine.

I did an upper gastrointestinal endoscopy, and it is fine. The ultrasound showed the ileum is full of air and there are no visible thickening. Then, I got UTI, and I was given Macrobid antibiotics for it. This antibiotic helped my stomach also, as the burping had stopped. But, the symptoms started again when I stopped taking the tablets. It always feels like something inside is irritating, and I saw fresh blood in the stool one time. Probiotics do not help much, and I cannot sit for long because it feels like my anus will explode. The food is not passing normally through the gastrointestinal tract.

It all started after taking some Magnesium pill. I felt as if something was swollen from the inside, and I passed less stool. Then I was given PPI, and it made things worse. Bending over makes me nauseous. All this is going on from the past three months. I even stopped smoking, but it is not getting better. Whenever I smoke, I start feeling nauseous again. I know it is not stress-related or IBS. How much of small intestine is seen using colonoscopy? What could this be? I lost weight due to poor absorption. I do not think it is cancer, as I had a colonoscopy two years ago, and it was fine, but back then, I had no such problems. What test needs to be done? Will an x-ray with barium show if there is an ulcer or inflammation or obstruction? What do you suggest? It is ruing my life.

Dr. Babu Lal Meena

Child Health Medical Gastroenterology Paediatrics


Welcome to icliniq.com.

Greetings of the day.

  • Yes, an x-ray with barium will definitely help to delineate the ulcer and obstruction. Sometimes, there is a subacute obstruction that leads to pain intermittently whenever there is distention of the bowel.
  • Losing weight is also indicative of some ongoing inflammation or infection or malignancy. By upper GI (gastrointestinal) endoscopy, we can see till jejunum. Ileum study requires colonoscopy. But we can avoid these invasive and painful procedures.
  • If the pain is aggravated by feeding, then angiogram is also required to look at the patency of the vessels to rule out mesenteric ischemia. Important differential diagnosis in this case are:
  1. IBS (irritable bowel syndrome).
  2. Tuberculosis.
  3. IBD (irritable bowel disease).
  4. Cancer.
  5. Mesenteric ischemia.
  6. Intestinal motility disorders, etc.
  • I suggest you get the following tests done:
  1. X-ray abdomen.
  2. CT or MRI enteroclysis.
  3. Complete blood count with peripheral smear examination with ESR (erythrocyte sedimentation rate).
  4. Liver function tests.
  5. Kidney function tests.
  6. Stool calprotectin.

Revert with more information to a medical gastroenterologist online --> https://www.icliniq.com/ask-a-doctor-online/medical-gastroenterologist

Hello doctor,

Thank you for replying. I would like to know what is seen in an MRI enteroclysis? Does it show both, small and large intestines? What conditions can we see with it? I am sending you my x-ray of the abdomen, can you tell me if any growth or obstruction is seen? Is there anything that would indicate an obstruction? Could my problems be due to overgrowth of bacteria in the small intestines? Because antibiotics did help, but it all started again.

Dr. Babu Lal Meena

Child Health Medical Gastroenterology Paediatrics


Welcome back to icliniq.com.

The attached x-ray is not very clear (attachment removed to protect patient identity), so please upload a better x-ray.

  • MRI enteroclysis can see small as well as the large intestine. And, it can see the luminal lesions in form of ulcer and irregularity of the intestine.
  • Bacterial overgrowth is unlikely because it should not recur after taking antibiotics. Anyway, we should discuss with reports only. Kindly provide better quality reports.

Have a nice day.

Revert with more information to a medical gastroenterologist online --> https://www.icliniq.com/ask-a-doctor-online/medical-gastroenterologist

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