How Does Tobacco Affect GERD?
When you eat, a muscular ring between the end of the esophagus and the entrance to the stomach — called the lower esophageal sphincter (LES) — relaxes to let food in. Once it has closed again, the stomach releases acids and enzymes to break down the food. Usually, these acids stay put in the stomach. But in people with GERD, the sphincter may stay relaxed or relax at the wrong time. This allows stomach contents containing acids and enzymes to wash back up, irritating the tissue of the esophagus. Experts believe tobacco might worsen heartburn in a number of ways, including: • Impairing the function of the LES. “The nicotine in tobacco seems to lower the pressure in the lower esophageal sphincter,” says Cheskin. The reduced pressure could allow stomach acids and enzymes to back into the esophagus. • Increasing acidity. Nicotine increases the production of stomach acid, says Carr-Locke. • Harming the esophagus. Tobacco smoke seems to directly irritate the esophagus lining, says Cheskin.
