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. 1998 Oct;43(4):537–541. doi: 10.1136/gut.43.4.537

Effect of chronic and acute cigarette smoking on the pharyngo-upper oesophageal sphincter contractile reflex and reflexive pharyngeal swallow

K Dua 1, E Bardan 1, J Ren 1, Z Sui 1, R Shaker 1
PMCID: PMC1727281  PMID: 9824582

Abstract

Background—Cigarette smoking is known to affect adversely the defence mechanisms against gastro-oesophageal reflux. The effect of smoking on the supraoesophageal reflexes that prevent aspiration of gastric contents has not been previously studied. 
Aims—To elucidate the effect of cigarette smoking on two of the supraoesophageal reflexes: the pharyngo-upper oesophageal sphincter (UOS) contractile reflex; and the reflexive pharyngeal swallow. 
Methods—Ten chronic smokers and 10 non-smokers were studied, before and 10 minutes after real or simulated smoking, respectively. UOS pressure and threshold volume for the reflexes were determined using a UOS sleeve assembly. Two modes of fluid delivery into the pharynx were tested: rapid injection and slow injection. 
Results—For both rapid and slow injections, the threshold volume for triggering the pharyngo-UOS contractile reflex was significantly higher in smokers than in non-smokers (rapid: smokers 0.42 (SE 0.07) ml, non-smokers 0.16 (0.04) ml; slow: smokers 0.86 (0.06) ml, non-smokers 0.38 (0.1) ml; p<0.05). During rapid injection, the threshold volume for reflexive pharyngeal swallow was higher in smokers (smokers 0.94 (0.09) ml, non-smokers 0.46 (0.05) ml; p<0.05). Acute smoking further increased the threshold volume for the pharyngo-UOS contractile reflex and reflexive pharyngeal swallow during rapid injection. 
Conclusions—Smoking adversely affects stimulation of the pharyngo-UOS contractile reflex and pharyngeal reflexive swallow. These findings may have implications in the development of reflux related respiratory complications among smokers. 



Keywords: smoking; supraoesophageal reflexes; pharyngo-upper oesophageal sphincter contractile reflex; reflexive pharyngeal swallow; airway protection; gastro-oesophageal reflux

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Figure 1 .

Figure 1

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Diagram of the manometry sleeve catheter positioned across the UOS. 


Figure 2 .

Figure 2

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Number of spontaneous swallows per minute. *p<0.05. 


Figure 3 .

Figure 3

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UOS pressure following rapid (A) and slow injection (B) of water into the pharynx. E1, E2, E3, proximal oesophageal perfusion ports; S, swallow. 


Figure 4 .

Figure 4

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Threshold volume required for triggering the pharyngo-UOS contractile reflex. *p<0.05, slow versus rapid injection; †p<0.05, post-smoking versus pre-smoking; ‡p<0.05, smokers versus non-smokers. 


Figure 5 .

Figure 5

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Threshold volume required for triggering reflexive pharyngeal swallow. *p<0.05, slow versus rapid injection; †p<0.05, post-smoking versus pre-smoking; ‡p<0.05, smokers versus non-smokers. 


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These references are in PubMed. This may not be the complete list of references from this article.

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