All Nicotine Is Created Equal: It’s BAD for Reflux, Both GERD and LPR
The lower esophageal sphincter (LES) is the most critical barrier preventing the backflow (reflux) of stomach contents upwards into the esophagus, and the throat is the lower esophageal sphincter (LES). It has been shown that nicotine makes the LES sphincter relax, like a pharmacological drug effect.
The author (Koufman) examined the reflux testing (pH-monitoring) data of 750 known (smoking and non-smoking) reflux patients and showed that reflux was twice as severe in smokers. It has been reported that reflux events occur within two minutes, with two-thirds of cigarettes smoking. Furthermore, it has been shown that smoking and smokeless tobacco are linked to Barrett’s esophagus, considered an esophageal pre-cancer.
In conclusion, all forms of nicotine use — smoking, vaping, pipe, cigarette, water pipe (hookah), and all forms of smokeless tobacco — are associated with causing and worsening acid reflux, both GERD and LPR, and their sequelae.
