Smoking and reflux

[Random_Design]

Does smoking affect digestion in such a way as to cause reflux? if so, how?
(I just mean, the reflux comes from the valve not closing right? so how would smoking affect it to make it worse? I think I’m missing something obvious)

[x-ray_vision]

If go to Google and type in “smoking reflux” without the quotation marks, you’ll get a ton of hits. From the first hit:

Studies indicate that smoking relaxes the lower esophageal sphincter (LES). When the LES relaxes or is not functioning properly, acidic stomach juices can reflux into the esophagus, which results in the sensation known as heartburn.

One report showed that esophageal acid exposure increased by over 50 percent after smoking. Interestingly, heartburn episodes were more frequent - 114 percent more likely to occur - during the daytime when sufferers were standing upright. (Typically the force of gravity works in heartburn sufferers’ favor during the day.)

Other studies have shown that smoking has harmful effects on salivary function that result in a longer than normal time to remove or “clear” the esophagus of any acid.1,8 The longer it takes for acid to be cleared, the more damage can occur. Notably, other reports contend that smoking changes the composition of the saliva, which normally contains acid-neutralizing chemicals known as bicarbonates. Smokers’ saliva contains markedly smaller amounts of bicarbonates, thus reducing the ability of the saliva to neutralize stomach acid that can damage esophageal tissues.5,8

[irishgirl]

For a start, it’s not really a valve, or a true sphincter.
Here are the mechanisms (not terribly efficient) by which your body prevents reflux (or tries to anyway). The reason you don’t have true valve or sphincter is because sometimes it’s in your best interest to burp or vomit!

Info is from my copy of Last’s Anatomy.
" the fibres of the right crus (of the diaphragm)…form a sling around the abdominal oesophagus. Various factors contribute towards guarding against the reflux of gastric contents; these include the contraction of these right crus fibres, the angle of entry of the oesophagus into the stomach, the longitudinal folds of the oesophageal mucosa, a high pressure zone in the lower 3cm of oesophagus and the effect of positive intra-abdominal pressure on the abdominal segment of the oesophagus."

IIRC from my physiology lectures, the increased Nitric Oxide from cigarette smoke causes muscle relaxation, leading the entrance to the stomach becoming lax, and reflux more likely.

Whatever the mechanism, smoking has been shown to be a risk factor for Gastro-oesophageal Reflux Disease (GORD), and if you have heartburn and smoke(especially if the GORD isn’t responding well to medication) giving up cigarettes would be a good start.

[x-ray_vision]

BTW, it GERD here in the U.S. Apparently they can’t spell esophagus correctly in the U.K.

[irishgirl]

I know you spell it differently…I’m just doing my own little bit in the fight against American cultural imperialism!