Smoke and be damned

First of all, smoking hits the headquarters of the digestive system 8211; the liver. The effects of smoking on the liver are rarely mentioned, but researchers find that smoking alters the way the liver handles drugs including medicines and alcohol. The effect ofthese substances on a smoker is worse because his liver is less efficient at removing toxins. In medication, a smoker may need an altered dosage. If a heavy drinker also smokes, he is inviting greater damage from the same amount of alcohol.

Smoking seems to change the way in which normal food is processed by the body. The body of a smoker absorbs less nutrition and uses food less efficiently. So while the average smoker may weigh less than his non-smoking equal, the fitness is worse and nutritional deficiencies more. Just to stay on par, smokers need to consume greater amounts of vitamins.

The biggest digestive discomfort for smokers is acidity and heartburn, that burning feeling in the chest after a meal. This is often wrongly linked to spicy food. The burning sensation actually comes from strong stomach acids which have flowed backward from the stomach into the foodpipe. Normally the valve at the end of the food pipe prevents this backflow. But smoking among other factors loosens this valve. So whenthe smoker lies down, bends over, wears a tight belt or has a big meal, stomach acids wash upward into the food pipe. Moreover, smoking increases acid production in the stomach. As if that is not enough, it invites backward movement of bile salts and enzymes from the intestine. The result? The smoker8217;s upper digestive tract is awash in strongly acidic material. Cigarette smoke seems to directly injure the lining of the food pipe as well, so it is more sensitive in the acid.

Reseachers also know that ulcers whose exact cause is unknown are more likely to occur and are slower to heal, in a smoker. Experts have been investigating the connection. It has been found that not only does smoking raise acid secretion, the production of acid-neutralisers like sodium bicarbonate is temporarily reduced after smoking. There are also indications that smoking speeds up the emptying of acidic material from stomach into the intestine. The aggravated acidity could explain the ulcer-proneness of smokers. Any existingweakness of the stomach or intestine simply becomes worse or chronic with smoking, say experts.

If cancers of the digestive organs are also more common in smokers, there are plenty of explanations. It could be due to the 30 cancer-causing chemicals in tobacco smoke or due to the effect of enzymes and metabolites that the nicotine produces in the body. Then again, it could be the handiwork of free radicals released by the smoke. Take your pick!

Fortunately, a smoker is not permanently condemned to indigestion. There are indications that tobacco-damage to the digestive system can be reversed if the smoker kicks the habit. He may not be able to actually see his cancer risk going down, but he will enjoy some relief from acidity and heartburn.

Dr Rohini Kelkar is a member of Healthy Home Advisory Services HHAS and is head, department of microbiology, Tata Memorial Hospital