Eddie Thomas of Salem, Ore., has acid reflux and gastroesophageal reflux disease, or GERD, and he tells you about it in a raspy, scratchy tone.
"I'll wake up with acid in my throat," says Thomas, 33, taking a drag off his cigarette outside a shopping mall in Salem, Ore. "It's kind of why my voice is the way it is." He also suffers from frequent heartburn.
Thomas figures his GERD comes from his diet, which is pretty lousy. Or maybe from his weight. He's surprised when he's told that it might come from the cigarette he's smoking.
"I didn't even know that," Thomas says, dropping the cigarette to the ground.
Smoking and GERD
It's true: Studies have closely linked smoking to GERD, and smokers suffering from constant acid reflux often find some relief from their GERD once they quit.
Research also has linked smoking to some of the worst complications of GERD, including Barrett's esophagus and throat cancer.
Doctors say that smoking contributes to GERD by:
- Relaxing the lower esophageal sphincter. Nicotine tends to relax smooth muscle inside the body. One of the body's main defenses against GERD is the lower esophageal sphincter, a tight ring of muscle that connects the esophagus and the stomach. The sphincter regulates passage of food into the stomach, and prevents acid from refluxing into the esophagus. When nicotine causes the sphincter to relax, there's an increased risk of acid surging into and damaging the esophagus.
- Reducing salivation. Saliva contains an acid-neutralizing substance called bicarbonate, which helps fight the effects of acid reflux and GERD. Basically, when you swallow your saliva, it helps quell whatever acid damage is taking place due to reflux. Smokers produce less saliva, and so have less ability to neutralize refluxed acid.
- Increasing acid secretion in the stomach. Smoking prompts the stomach to produce more acid, increasing the risk of gastric juices being refluxed into the esophagus. Smoking also seems to make stomach acid more intense and damaging by promoting the transfer of bile salts from the intestines into the stomach.
- Interfering with the esophageal muscles. In relaxing smooth muscle, nicotine also can interfere with the muscles that help move food down the esophagus. These muscles help rid the esophagus of damaging acid reflux.
- Damages the esophageal lining. Smoking is harmful to mucus membranes that help protect the esophagus from acid damage.
It can be incredibly difficult to quit smoking, even if you have a pressing health reason like GERD. Here are some tips to help you quit:
- Talk to your doctor about medications that can help you quit, such as nicotine replacements or prescription drugs that can reduce cravings.
- Set a date when you will quit, and prepare yourself ahead of time for the cravings.
- Keep yourself busy, so you won't have time to think about your cravings.
- Make a list of your reasons for quitting, and refer to it when you're feeling bad.
- Avoid activities during which you usually smoke.
- Tell friends and family about your plans to quit, and ask for their support.
- Have things like candy, peppermint sticks, and carrots ready to put in your mouth in place of a cigarette.
Knowing the link between GERD and smoking just may give Thomas the incentive he needs to put down the cigarettes: "I know smoking is bad for me. I know I need to quit. This is just one more reason," Thomas says.