2. Gastric Ulcer

Research studies indicate that there is a strong causal relationship between gastric ulcer and smoking. The increased risk is probably limited to present smokers. According to the studies smoking has no effect on the healing or recurrence of gastric ulcer in cases of successful Helicobacter pylori infection eradication. However, there is some evidence that eradication therapy of Helicobacter pylori infections is less successful with smoking patients than with non-smokers.

Pathophysiology of Gastric Ulcer

The gastro-intestinal mucosa and bicarbonates neutralize gastric acids. If this protecting mechanism does not work well enough, or if the damaging factors are stronger than defensive mechanisms, a gastric ulcer will develop.

One of the most obvious mechanisms through which smoking can cause gastric ulcer, is that nicotine stimulates the secretion of gastric acid, and increases the retrograde flow of the acids (gastric reflux disease). Nicotine also reduces the effects of pancreatic alkaline secretions and prostaglandins. Prostaglandins are tissue hormones that have an effect on several organs.

There is some research evidence on the connection between smoking and gastric acid secretion. Smoking induces retrograde flow of the gastric acids to the stomach, increases the production of free radicals and enhances the release of vasopressin hormone, which reduces urine excretion and the urine becomes more concentrated.
Smoking inhibits constantly the secretion of mucus that takes place in the gastric mucosa, and it also affects the bicarbonate secretion in the pancreas.