Quit smoking improves gastroesophageal reflux symptoms and quality of life

Kou Nakajima, Akihito Nagahara, Akihiko Kurosawa, Kuniaki Seyama, Daisuke Asaoka, Taro Osada, Mariko Hojo, Sumio Watanabe

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DOI: 10.4236/health.2011.311114                

Abstract

Background: Smoking is considered to be risk factors of gastroesophageal reflux disease (GERD). The present study aimed to reveal whether quit smoking improves GERD symptoms and QOL of patients. Methods: In this prospective study, 33 patients who participated in a 12-week quit smoking program filled out the Frequency Scale for the Symptoms of GERD (FSSG) questionnaire, and SF8 QOL questionnaire. Patients filled out the questionnaires at baseline and during the program at 2 weeks, 4 weeks, 8 weeks and 12 weeks. In the FSSG, the responses were scored and the reflux score (RS), dysmotility score (DS) and total score (TS) were calculated. Results: There were 22 males and 11 females. Their mean age was 54.8 ± 13.0 (mean ± SD) yr, BMI was 22.9 ± 4.0, and duration of smoking was 33.5 ± 12.5 years. Ten patients belonged to GERD subgroup (baselineFSSGscore ≥ 8). All patients were successful at quit smoking. Scores of TS/RS/DS are 8.6 ± 1.8 (mean ± SE)/4.2 ± 0.9/4.5 ± 0.9 at baseline, 4.7 ± 1.6**/2.5 ± 0.9**/2.3 ± 0.7** at 2 w, 5.7 ± 1.3**/2.6 ± 0.6*/3.0 ± 0.7* at 4 w, 4.5 ± 1.4*/2.2 ± 0.8*/2.3 ± 0.8* at 8 w and 3.7 ± 1.2**/1.7 ± 0.6**/2.0 ± 0.7** at 12 w, respectively (**p < 0.01, *p < 0.05 vs. baseline). Among GERD subgroup, Scores of TS/RS/DS are 18.0 ± 2.9/8.9 ± 1.6/9.1 ± 1.5 at baseline, 8.8 ± 3.0/5.1 ± 1.7/3.7 ± 1.6 at 2 w, 10.8 ± 2.9/5.4 ± 1.6/5.4 ± 1.5 at 4 w, 7.6 ± 2.9*/4.1 ± 1.6/3.5 ± 1.5* at 8 w and 7.1 ± 2.9*/3.2 ± 1.6*/3.9 ± 1.5* at 12w, respectively. Regarding QOL, physical component score has significantly improved at 2, 4, 8 and 12 w and mental component score at 4w, respectively. Conclusions: Quit smoking significantly improved not only GERD symptoms but also QOL, indicating that quit smoking might be an option in the treatment strategy of GERD symptoms.

Keywords

Quit Smoking; FSSG; GERD; SF8

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Salter, R.H. (1974) Occasional Survey: Lower oesophageal sphincter. Therapeutic implications. Lancet, 7853, 347-349. doi:10.1016/S0140-6736(74)93088-8
[2]	Stanciu, C. and Bennett, J.R. (1972) Smoking and Gstroo-oesophageal reflux. British Medical Jounal, 30, 793-795.doi:10.1136/bmj.3.5830.793
[3]	Chattopadhyay, D.K., Greaney, M.G. and Irvin, T.T. (1977) Effect of cigarette smoking on the lower oesophageal sphincter. Gut, 18, 833-835. doi:10.1136/gut.18.10.833
[4]	Gritz, E.R., Carr, C.R. and Marcus, A.C. (1991) The tobacco withdrawal syndrome in unaided quitters. British Journal of Addiction, 86, 57-69.
[5]	Hajek, P., Gillison, F. and McRobbie, H. (2003) Stopping smoking can cause constipation. Addiction, 98, 1563- 1567. doi:10.1046/j.1360-0443.2003.00497.x
[6]	Kusano, M., Shimoyama, Y., Sugimoto, S., et al. (2004) Development and evaluation of FSSG: frequency scale for the symptoms of GERD. Journal of Gastroenterology, 39, 888-891. doi:10.1007/s00535-004-1417-7
[7]	Massarrat, S. (2008) Smoking and Gut. Archives of Iranian Medicine, 11, 293-305
[8]	Murthy, S.N., Dinosi, V.P. Jr, Clearfield, H.R. and Chey, W.J. (1977) Simultaneous measurement of basal pancreatic, gastric acid secretion, plasma gastrin, and secretin during smoking. Gastroenterology, 73, 758-761.
[9]	Miller, T.A. (1983) Protective effects of prostaglandins against gastric mucosal damage: current knowledge and proposed mechanisms. American Journal of Physiology, 245, G601-G623.
[10]	Quimby, G.F., Bonnice, C.A., Burstein, S.H. and Eastwood, G.L. (1986) Active smoking depresses prostaglandin synthesis in human gastric mucosa. Annals of Internal Medicine, 104, 616-619.
[11]	Smi,t C.F., Copper, M.P., van Leeuwen, J.A., Schoots, I.G. and Stanojcic, L.D. (2001) Effect of cigarette smoking on gastropharyngeal and gastroesophageal reflux. Annals of Otology, Rhinology, and Laryngology, 110, 190-193.
[12]	Kahrilas, P.J., Gupta, R.R. (1990) Mechanisms of acid reflux associated with cigarette smoking. Gut, 31, 4-10. doi:10.1136/gut.31.1.4
[13]	Miyamoto, M., Haruma, K., Takeuchi, K. and Kuwabara, M. (2008) Frequency scale for symptom of gastroesophageal reflux disease predicts the need for addition of prokinetics to proton pump inhibitor therapy. Journal of Gastroenterology and Hepatology, 23, 746-751. doi:10.1111/j.1440-1746.2007.05218.x
[14]	Oridate, N., Takeda, H., Mesuda, Y., et al. (2008) Evaluation of upper abdominal symptoms using the Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease in patients with laryngopharyngeal reflux symptoms. Journal of Gastroenterology, 43, 519-523. doi:10.1007/s00535-008-2189-2
[15]	Danjo, A., Yamaguchi, K., Fujimoto, K., et al. (2009) Comparison of endoscopic findings with symptom assessment systems (FSSG and QUEST) for gastroesophageal reflux disease in Japanese centres. Journal of Gastroenterology and Hepatology, 24, 633-638. doi:10.1111/j.1440-1746.2008.05747.x
[16]	Fujiwara, Y. and Arakawa, T. (2009) Epidemiology and clinical characteristics of GERD in the Japanese population. Journal of Gastroenterology, 44, 518-534. doi:10.1007/s00535-009-0047-5
[17]	Nagahara, A., Asaoka, D., Hojo, M., et al. (2010) Observational comparative trial of the efficacy of proton pump inhibitors versus histamine-2 receptor antagonists for uninvestigated dyspepsia. Journal of Gastroenterology and Hepatology, 25, S122-128. doi:10.1111/j.1440-1746.2009.06218.x
[18]	Hongo, M., Miwa, H., Kusano, M., J-FAST group. (2011) Effect of rabeprazole treatment on health-related quality of life and symptoms in patients with reflux esophagitis: a prospective multicenter observational study in Japan. Journal of Gastroenterology, 46, 297-304. doi:10.1007/s00535-010-0342-1
[19]	Thomson, A.B., Barkun, A.N., Armstrong, D., et al. (2003) The prevalence of clinically significant endoscopic findings in primary care patients with uninvestigated dyspepsia: the Canadian Adult Dyspepsia Empiric Treatment—Prompt Endoscopy (CADET-PE) study. Alimentary Pharmacology & Therapeutics, 17, 1481- 1491.doi:10.1046/j.1365-2036.2003.01646.x
[20]	The Japanese Society of Gastroenterology. GERD management guideline. (2009) The Japanese Society of Gastroenterology, Tokyo,(in Japanese)
[21]	Lin, C.C., Wang, Y.Y., Wang, K.L., et al. (2009) Association of heartburn and laryngopharyngeal symptoms with endoscopic reflux esophagitis, smoking, and drinking. Otolaryngology—Head and Neck Surgery, 141, 264-271. doi:10.1016/j.otohns.2009.05.017
[22]	Belafsky, P.C., Postma, G.N. and Koufman, J.A. (2002) Validity and reliability of the reflux symptom index (RSI). Journal of Voice, 16, 274-277. doi:10.1016/S0892-1997(02)00097-8
[23]	Hays, J.T., Croghan, I.T., Baker, C.L., Cappelleri, J.C. and Bushmakin, AG. (2010) Changes in health-related quality of life with smoking cessation treatment. Eur J Public Health. 30 September 2010. [Epub ahead of print]
[24]	Jang, A.S., Park, S.W., Kim, D.J., et al. (2010) Effects of smoking cessation on airflow obstruction and quality of life in asthmatic smokers. Allergy, Asthma and Immunology Research, 2, 254-259. doi:10.4168/aair.2010.2.4.254