Does smoking make heartburn worse?

BY: Jane Shiyen Chou

Possibly, says Dr. Lauren B. Gerson, a Stanford University School of Medicine gastroenterologist who has studied the connection between heartburn and lifestyle factors like smoking. Here’s what researchers have found:

• Smokers report higher rates of heartburn than do nonsmokers.
• Smoking relaxes the lower esophageal sphincter (LES). Since the LES is the “gate” that’s supposed to keep acid in your stomach from creeping back up into your esophagus and causing heartburn, having a more relaxed LES makes heartburn more likely.
• Smoking may decrease saliva, making it harder for your body to wash down any acid that backs up into your esophagus.
• Smoking causes you to cough or take sudden deep breaths. This in turn increases pressure in your abdomen, which can push acid back up into your esophagus, resulting in heartburn.

However, despite all of the above, when researchers have studied smokers who stop, their heartburn symptoms did not improve.

So should you quit smoking if you have heartburn? “There’s currently no evidence that smoking cessation will decrease heartburn symptoms or cure it,” says Gerson. “But I tell my patients to stop smoking because smoking is linked to increased risk of cancer and emphysema.”