Practical Practitioner
By: Pamela Egan, FNP-C CDE
Smoking can negatively affect your digestive system
Dear Pam,
I’m 23 years old and have been suffering from severe heartburn. I go through three bottles of TUM’s a week without much relief. I smoke a pack and a half of cigarettes a day. My friend said that smoking can lead to heartburn. Is this true?
Your friend is absolutely right!
In addition to damaging the lungs and heart, smoking can have detrimental effects on the digestive system.
Smoking has been shown to contribute to heartburn, peptic ulcers and changes in liver function. It also affects the way food is processed by the body.
Heartburn occurs when the esophagus comes into contact with acid, bile salts and digestive enzymes from the stomach.
Normally, a muscular valve located at the base of the esophagus keeps this acid solution in the stomach and out of the esophagus.
This valve is called the lower esophageal sphincter.
If this sphincter allows acid to flow backward, or reflux, into the esophagus, prolonged contact can cause burning pain and injury to the esophageal lining.
Smoking has been shown to weaken the lower esophageal sphincter, which increases the likelihood of reflux and its symptoms. In addition, smoking may promote the movement of bile salts from the intestines to the stomach, making the refluxed material more harmful to the esophagus.
Other studies have shown that smoking can injure the esophagus directly, making its lining more susceptible to damage from reflux of stomach acids.
An ulcer is an open sore in the lining of the stomach or duodenum, the first part for the small intestine. While the exact cause of ulcers is unknown, a relationship between ulcers, especially duodenal ulcers, and smoking does exist.
A 1989 report by the surgeon general stated that smokers are more likely to develop ulcers than nonsmokers, and that ulcers in smokers are less likely to heal and more likely to cause death.
A smoker’s ulcer is also less likely to respond to treatments that are normally effective in nonsmokers.
Smoking has been shown to be one of the many factors that lead to the formation of ulcers.
Some studies have indicated that smoking decreases the production of sodium bicarbonate by the pancreas.
Sodium bicarbonate is an alkali that neutralizes acid that passes from the stomach into the duodenum. Smoking may also increase the amount of acid produced in the stomach.
Other studies suggest that smoking increases the speed at which the stomach empties its acid into the small intestine.
While the exact link between smoking and ulcers has not been proven, the evidence does suggest that smokers with ulcers should quit.
Most of the effects of smoking on the digestive system seem to resolve quickly if the person stops smoking.
Some effects, including the production of sodium bicarbonate by the pancreas, return to normal within half hour after smoking.
Liver function also returns to normal within a short time.
While little research has been done on other digestive problems related to smoking, most healthcare providers believe that these will also resolve with smoking cessation.
This article was originally published July 18, 2005 in The St. Tammany News.
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