Why Does Smoking Cause Heartburn?

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Updated March 07, 2014.

There's more than one health reason for kicking the smoking habit, but one condition you may not have thought of is heartburn. You may be thinking smoking would have more effect on the lungs, mouth, and throat — but the stomach? You may be surprised at what effect smoking actually has on the body.

How Smoking Can Cause Heartburn
 

  • Smoking and Saliva Production
    Cigarette smoking slows the production of saliva, one of your body's defenses against damage to the esophagus. There are even acid-neutralizing chemicals in saliva, called bicarbonates. Research shows that the saliva of smokers contains smaller amounts of bicarbonates, thus reducing the ability of the saliva to neutralize the acid. Saliva also bathes the esophagus and lessens the effects of acid that has refluxed up from the stomach, and helps wash the acid down to the stomach.


  • Smoking and Too Much Stomach Acid
    Smoking stimulates the production of stomach acid.
  • Smoking and How it Weakens Digestive Valves Smoking can weaken and relax the lower esophageal sphincter (LES), which is a valve at the junction between esophagus and stomach. If the LES isn't working properly or relaxes inappropriately, stomach contents can reflux back up into the esophagus.
  • Smoking and How it Changes Stomach Acid
    Smoking also seems to promote the movement of bile salts from the intestine to the stomach, which makes the stomach acids more harmful.
  • How Smoking Can Injure the Esophagus
    Smoking may directly injure the esophagus, making it even more susceptible to further damage from acid reflux.
  • Smoking and Slowing Digestion
    Studies have shown that smokers have decreased gastric motility (digestion) while smoking, which can cause less efficient digestion because the stomach takes longer to empty. 

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Smoking and Its Harmful Effects On Other Areas of the Digestive System

Besides increasing the risk of suffering from heartburn, smoking can have other undesirable effects on the digestive system.

Among the areas of the digestive system that can be affected by smoking, besides the developing of heartburn, are peptic ulcers, and the risk of developing gallstones. 

Peptic Ulcer

peptic ulcer is an open sore in the lining of the stomach or duodenum, the first part of the small intestine. The exact cause of ulcers is not known. A relationship between smoking cigarettes and ulcers, especially duodenal ulcers, does exist. The 1989 Surgeon General's report stated that ulcers are more likely to occur, less likely to heal, and more likely to cause death in smokers than in nonsmokers.

Why is this so? Doctors are not really sure, but smoking does seem to be one of several factors that work together to promote the formation of ulcers.

For example, some research suggests that smoking might increase a person's risk of infection with the bacterium Helicobacter pylori (H. pylori). Most peptic ulcers are caused by this bacterium.

Stomach acid is also important in producing ulcers. Normally, most of this acid is buffered by the food we eat. Most of the unbuffered acid that enters the duodenum is quickly neutralized by sodium bicarbonate, a naturally occurring alkali produced by the pancreas. Some studies show that smoking reduces the bicarbonate produced by the pancreas, interfering with the neutralization of acid in the duodenum. Other studies suggest that chronic cigarette smoking may increase the amount of acid secreted by the stomach.

Whatever causes the link between smoking and ulcers, two points have been repeatedly demonstrated: People who smoke are more likely to develop an ulcer, especially a duodenal ulcer, and ulcers in smokers are less likely to heal quickly in response to otherwise effective treatment. This research tracing the relationship between smoking and ulcers strongly suggests that a person with an ulcer should stop smoking.

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Gallstones

Several studies suggest that smoking may increase the risk of developing gallstones and that the risk may be higher for women. However, research results on this topic are not consistent, and more study is needed. 

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Useful Resources:

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Source:

Carol Ann Rinzler; Ken DeVault, MD, First. Heartburn & Reflux For Dummies. Wiley Publishing, Inc, 2004. 163-176. Print.

Mayo Foundation for Medical Education and Research - John E King, M.D., Editor in Chief, First. Mayo Clinic on Digestive Health. Kensington Publishing, 2000. 70. Print.

Steven R. Peikin, M.D., First. Gastrointestinal Health. First Edition. Harper Perennial (Harper Collins Publishers), 1999. 40. Print.
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