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. 1973 Aug 11;3(5875):313–316. doi: 10.1136/bmj.3.5875.313

Effect of Cigarette Smoking on Competence of the Pylorus: Preliminary Study

N W Read, P Grech
PMCID: PMC1586495  PMID: 4723811

Abstract

The competence of the pylorus was studied in 13 normal volunteers and nine dyspeptic patients by means of a radiological technique involving intubation of the duodenum. The pylorus was found to be competent in most normal individuals and in fewer than half of the dyspeptic patients. However, on smoking a cigarette, appreciable increase in duodenogastric reflux was seen in nine out of the 13 normal volunteers and in seven out of the nine dyspeptic patients. Such induced pyloric incompetence and the resultant regurgitation of duodenal juices may explain the increased incidence of gastritis and gastric ulceration in heavy smokers.

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Selected References

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  1. Andersson S., Grossman M. I. Profile of pH, pressure, and potential difference at gastroduodenal junction in man. Gastroenterology. 1965 Oct;49(4):364–371. [PubMed] [Google Scholar]
  2. Armitage A. K., Turner D. M. Absorption of nicotine in cigarette and cigar smoke through the oral mucosa. Nature. 1970 Jun 27;226(5252):1231–1232. doi: 10.1038/2261231a0. [DOI] [PubMed] [Google Scholar]
  3. Aste H., Lucchini A., Avendano S., Medina L. A., Aguilar L. Duodeno-gastric reflux. An endoscopic study. Gastrointest Endosc. 1972 Aug;19(1):11–12. doi: 10.1016/s0016-5107(72)73932-2. [DOI] [PubMed] [Google Scholar]
  4. Bedi B. S., Debas H. T., Gillespie G., Gillespie I. E. Effect of bile salts on antral gastrin release. Gastroenterology. 1971 Feb;60(2):256–262. [PubMed] [Google Scholar]
  5. Beeley M., Grech P. Pyloric incompetence in chronic non-specific lung disease. Gut. 1971 Feb;12(2):102–106. doi: 10.1136/gut.12.2.102. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Beneventano T. C., Schein C. J. Pyloric sphincter incompetence in man. A physiological variant. Gastroenterology. 1970 Oct;59(4):518–521. [PubMed] [Google Scholar]
  7. Bennett J. R. Smoking and the gastrointestinal tract. Gut. 1972 Aug;13(8):658–665. doi: 10.1136/gut.13.8.658. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Black R. B., Hole D., Rhodes J. Bile damage to the gastric mucosal barrier: the influence of pH and bile acid concentration. Gastroenterology. 1971 Aug;61(2):178–184. [PubMed] [Google Scholar]
  9. Black R. B., Roberts G., Rhodes J. The effect of healing on bile reflux in gastric ulcer. Gut. 1971 Jul;12(7):552–558. doi: 10.1136/gut.12.7.552. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Capper W. M., Airth G. R., Kilby J. O. A test for pyloric regurgitation. Lancet. 1966 Sep 17;2(7464):621–623. doi: 10.1016/s0140-6736(66)91930-1. [DOI] [PubMed] [Google Scholar]
  11. DAVENPORT H. W. DAMAGE TO THE GASTRIC MUCOSA: EFFECTS OF SALICYLATES AND STIMULATION. Gastroenterology. 1965 Aug;49:189–196. [PubMed] [Google Scholar]
  12. DAVENPORT H. W. GASTRIC MUCOSAL INJURY BY FATTY AND ACETYLSALICYLIC ACIDS. Gastroenterology. 1964 Mar;46:245–253. [PubMed] [Google Scholar]
  13. DAVENPORT H. W., WARNER H. A., CODE C. F. FUNCTIONAL SIGNIFICANCE OF GASTRIC MUCOSAL BARRIER TO SODIUM. Gastroenterology. 1964 Aug;47:142–152. [PubMed] [Google Scholar]
  14. DOLL R., JONES F. A., PYGOTT F. Effect of smoking on the production and maintenance of gastric and duodenal ulcers. Lancet. 1958 Mar 29;1(7022):657–662. doi: 10.1016/s0140-6736(58)91083-3. [DOI] [PubMed] [Google Scholar]
  15. DUPLESSIS D. J. PATHOGENESIS OF GASTRIC ULCERATION. Lancet. 1965 May 8;1(7393):974–978. doi: 10.1016/s0140-6736(65)91214-6. [DOI] [PubMed] [Google Scholar]
  16. Davenport H. W. Is the apparent hyposecretion of acid by patients with gastric ulcer a consequence of a broken barrier to diffusion of hydrogen ions into the gastric mucosa? Gut. 1965 Oct;6(5):513–513. doi: 10.1136/gut.6.5.513. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Debas H. T., Cohen M. M., Holubitsky I. B., Harrison R. C. Effect of cigarette smoking on human gastric secretory responses. Gut. 1971 Feb;12(2):93–96. doi: 10.1136/gut.12.2.93. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Delaney J. P., Cheng J. W., Butler B. A., Ritchie W. P., Jr Gastric ulcer and regurgitation gastritis. Gut. 1970 Aug;11(8):715–719. doi: 10.1136/gut.11.8.715. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. EDWARDS F., McKEOWN T., WHITFIELD A. G. Association between smoking and disease in men over sixty. Lancet. 1959 Jan 24;1(7065):196–200. doi: 10.1016/s0140-6736(59)90385-x. [DOI] [PubMed] [Google Scholar]
  20. Edwards F. C., Coghill N. F. Aetiological factors in chronic atrophic gastritis. Br Med J. 1966 Dec 10;2(5527):1409–1415. doi: 10.1136/bmj.2.5527.1409. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Fisher R. S., Cohen S. Pyloric-sphincter dysfunction in patients with gastric ulcer. N Engl J Med. 1973 Feb 8;288(6):273–276. doi: 10.1056/NEJM197302082880601. [DOI] [PubMed] [Google Scholar]
  22. Flint F. J., Grech P. Pyloric regurgitation and gastric ulcer. Gut. 1970 Sep;11(9):735–737. doi: 10.1136/gut.11.9.735. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Geall M. G., Phillips S. F., Summerskill W. H. Profile of gastric potential difference in man. Effects of aspirin, alcohol, bile, and endogenous acid. Gastroenterology. 1970 Apr;58(4):437–443. [PubMed] [Google Scholar]
  24. Grech P. A technique for assessing pyloric reflux. Gut. 1970 Sep;11(9):794–795. doi: 10.1136/gut.11.9.794. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Ivey K. J., DenBesten L., Clifton J. A. Effect of bile salts on ionic movement across the human gastric mucosa. Gastroenterology. 1970 Nov;59(5):683–690. [PubMed] [Google Scholar]
  26. Ivey K. J., Denbesten L., Clifton J. A. Effect of intragastric bile salts on ionic movement across normal human gastric mucosa after intravenous atropine. Gut. 1971 Apr;12(4):257–261. doi: 10.1136/gut.12.4.257. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Jamieson R. A., Illingworth C. F., Scott L. D. Tobacco and Ulcer Dyspepsia. Br Med J. 1946 Aug 31;2(4469):287–288. [PMC free article] [PubMed] [Google Scholar]
  28. Janowitz H. D. Bile in the stomach. Gastroenterology. 1969 Sep;57(3):356–357. [PubMed] [Google Scholar]
  29. LAWSON H. H. EFFECT OF DUODENAL CONTENTS ON THE GASTRIC MUCOSA UNDER EXPERIMENTAL CONDITIONS. Lancet. 1964 Feb 29;1(7331):469–472. doi: 10.1016/s0140-6736(64)90800-1. [DOI] [PubMed] [Google Scholar]
  30. Monson R. R. Cigarette smoking and body form in peptic ulcer. Gastroenterology. 1970 Mar;58(3):337–344. [PubMed] [Google Scholar]
  31. Overholt B. F., Pollard H. M. Acid diffusion into the human gastric mucosa. Gastroenterology. 1968 Feb;54(2):182–189. [PubMed] [Google Scholar]
  32. PIPER D. W., RAINE J. M. Effect of smoking on gastric secretion. Lancet. 1959 Apr 4;1(7075):696–698. doi: 10.1016/s0140-6736(59)91884-7. [DOI] [PubMed] [Google Scholar]
  33. Rhodes J., Barnardo D. E., Phillips S. F., Rovelstad R. A., Hofmann A. F. Increased reflux of bile into the stomach in patients with gastric ulcer. Gastroenterology. 1969 Sep;57(3):241–252. [PubMed] [Google Scholar]
  34. Rhodes J. Etiology of gastric ulcer. Gastroenterology. 1972 Jul;63(1):171–182. [PubMed] [Google Scholar]
  35. TOON R. W., CROSS F. S., WANGENSTEEN O. H. Effect of inhaled cigarette smoke on production of peptic ulcer in the dog. Proc Soc Exp Biol Med. 1951 Aug;77(4):866–869. doi: 10.3181/00379727-77-18951. [DOI] [PubMed] [Google Scholar]
  36. Wilkinson A. R., Johnston D. Inhibitory effect of cigarette smoking on gastric secretion stimulated by pentagastrin in man. Lancet. 1971 Sep 18;2(7725):628–632. doi: 10.1016/s0140-6736(71)80070-3. [DOI] [PubMed] [Google Scholar]

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