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Best Pract Res Clin Gastroenterol. 2017 Oct;31(5):501-508. doi: 10.1016/j.bpg.2017.09.004. Epub 2017 Sep 7.

Tobacco smoking, alcohol consumption and gastro-oesophageal reflux disease.

Author information

1
Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, Sweden; HUNT Research Centre, Department of General Practice and Nursing, NTNU, Norwegian University of Science and Technology, Forskningsvegen 2, 7600 Levanger, Norway; Medical Department, Levanger Hospital, Nord-Tr√łndelag Hospital Trust, P.O. Box 333, 7601 Levanger, Norway. Electronic address: eivind.ness-jensen@ki.se.
2
Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, Sweden; School of Cancer Sciences, King's College London, SE1 9RT, United Kingdom. Electronic address: jesper.lagergren@ki.se.

Abstract

Gastro-oesophageal reflux disease (GORD) develops when reflux of gastric content causes troublesome symptoms or complications. The main symptoms are heartburn and acid regurgitation and complications include oesophagitis, strictures, Barrett's oesophagus and oesophageal adenocarcinoma. In addition to hereditary influence, GORD is associated with lifestyle factors, mainly obesity. Tobacco smoking is regarded as an aetiological factor of GORD, while alcohol consumption is considered a triggering factor of reflux episodes and not a causal factor. Yet, both tobacco smoking and alcohol consumption can reduce the lower oesophageal sphincter pressure, facilitating reflux. In addition, tobacco smoking reduces the production of saliva rich in bicarbonate, which is important for buffering and clearance of acid in the oesophagus. Alcohol also has a direct noxious effect on the oesophageal mucosa, which predisposes to acidic injury. Tobacco smoking cessation reduces the risk of GORD symptoms and avoidance of alcohol is encouraged in individuals where alcohol consumption triggers reflux.

KEYWORDS:

Causality; Disease management; Ethanol; Gastroesophageal reflux; Smoking; Tobacco

PMID:
29195669
DOI:
10.1016/j.bpg.2017.09.004
[Indexed for MEDLINE]

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