Can Stomach Ulcers Lead to Stomach Cancer?
Smoking and Ulcers
Smoking increases the risk of ulcers and may hinder the drugs you're taking to heal your ulcer.
By Norra MacReady
Medically Reviewed by Pat F. Bass III, MD, MPH
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If you need yet another reason to toss the cigarettes, consider this: Smoking increases your risk of developing a peptic ulcer, and it can make that ulcer slower to heal.
In one study of more than 4,000 smokers and non-smokers 18 to 30 years old, researchers at the University of Minnesota found that the smokers were nearly twice as likely to have numerous ailments, including ulcers, when they were re-examined 7 to 15 years later.
Smoking Interferes With Stomach Acid
Cigarettes interfere with the body’s natural protective mechanisms against stomach acid.
Normally, this acid starts breaking food down as it hits the stomach, priming the food for the more powerful digestive enzymes it will encounter further down the digestive tract.
Whatever acid isn’t absorbed is neutralized by sodium bicarbonate, a natural antacid. This neutralization occurs in the duodenum, the first part of the intestine. Sodium bicarbonate is made by the pancreas, a vital organ that sits next to the duodenum.
There’s evidence to suggest that smoking increases stomach acid production over time, and that it reduces bicarbonate production. The duodenum, the first part of the small intestine, is also a major ulcer site. Smokers are particularly at risk of developing duodenal ulcers. They can also develop ulcers in the esophagus, the body part that leads to the stomach.
Smoking Interferes With Ulcer Drugs
Cigarettes also wreak their havoc in other ways, says Michael Brown, MD, a gastroenterologist and associate professor of medicine at Rush University Medical Center in Chicago.
Smoking may interfere with the action of drugs that can decrease stomach acid production, Dr. Brown warns.
The two most widely recommended classes of medications for this purpose are proton pump inhibitors, such as omeprazole (Prilosec), and H2 blockers, like ranitidine (Zantac). Smoking while using them sabotages your chances of getting relief from ulcer pain in three ways:
- Exacerbating the conditions that caused the ulcer to begin with
- Slowing down the rate at which the ulcer can heal
- Preventing the drugs from doing their job
Smoking Causes Other Digestive Problems
Brown says that smoking affects the digestive tract in other ways, which can make diagnosing and treating an ulcer more complicated. It contributes to acid reflux and heartburn by weakening the sphincter muscle that normally prevents stomach acid from flowing up into the esophagus.
Smoking also increases the risk of stomach and esophageal cancer and Crohn’s disease, a severe and painful inflammation of the intestinal lining that often requires removing one or more parts of the digestive tract. Compared with non-smokers, people with Crohn’s disease who smoke may experience more symptom flare-ups and may require more powerful drugs or even repeat surgeries to keep their symptoms under control.
And as if all that weren’t enough, smoking also has been linked to problems with the liver and gallbladder, two more organs that play an important role in digestion.
Ulcer: Reversible Damage
This nicotine cloud does have a silver lining: Much of the smoking-related damage to the digestive system can be reversed when you quit. In fact, some of its effects are surprisingly brief. The rate of sodium bicarbonate production returns to normal within 30 minutes after your last cigarette. Liver function also returns to normal soon after smoking stops. The effect on Crohn’s disease risk is less clear, and some doctors believe it persists even after you quit.
Still, if you have an ulcer, you can help your body to heal by throwing away the cigarettesnow.
Video: Stomach Ulcer | Nucleus Health
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