How Does Smoking Cause Heartburn?

7 reasons to kick the sticks

woman smoking cigarette
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There are numerous reasons for you to kick your smoking habit, but did you know that doing so may stop your heartburn? Smoking effects not just your lungs, mouth, and throat, but also your stomach. You may be surprised at what effect smoking actually has on the body.

6 Ways Smoking Causes Heartburn

  1. 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.
  1. Smoking stimulates the production of stomach acid. Too much stomach acid can cause reflux.
  2. 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.
  3. Smoking 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.
  4. Smoking may directly injure the esophagus, making it even more susceptible to further damage from acid reflux.
  5. Smoking slows 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. 

Smoking's 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. 

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. 



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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