Smoking and Ulcer Healing — Role for Prostaglandins?

  • E. J. S. Boyd
  • K. G. Wormsley
Conference paper


Cigarette smoking is causally related to duodenal ulcer (DU) and gastric ulcer (GU) disease: there is an increased incidence of DU [1] and GU [2] in patients who are smokers compared with non-smokers; there is a dose-response, in that the greater the number of cigarettes a patient smokes and the longer the history of smoking, the greater the relative risk of developing an ulcer [3]; and cigarette smoking is associated with pathophysiological abnormalities which may predispose to or aggravate duodenal or gastric ulcer disease (Table 1). In addition, cigarette smoking is associated with a slower rate of healing of duodenal and gastric ulcers during treatment with a variety of non-prostaglandin ulcer-healing drugs or placebo [4].


Cigarette Smoking Duodenal Ulcer Gastric Ulcer Gastric Mucosal Blood Flow Duodenal Ulcer Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Friedman GD, Siegelaub AB, Seltzer CC (1974) Cigarettes, alcohol, coffee, and peptic ulcer, New Eng J Med 290: 469–473PubMedCrossRefGoogle Scholar
  2. 2.
    Doll R, Jones FA, Pygott F (1958) Effect of smoking on the production and maintenance of gastric and duodenal ulcers, Lancet 1: 657–662PubMedCrossRefGoogle Scholar
  3. 3.
    Ainley CC, Forgacs IC, Keeling PWN, Thompson RPH (1986) Outpatient endoscopic survey of smoking and peptic ulcer, Gut 27: 648–651PubMedCrossRefGoogle Scholar
  4. 4.
    Kikendall JW, Evbaul J, Johnson LF (1984) Effect of cigarette smoking on gastrointestinal physiology and non-neoplastic digestive desease, J Clin Gastroenterol 6: 65–78PubMedGoogle Scholar
  5. 5.
    Vantrappen G, Janssens J, Popiela T, (1982) Effect of 15(R)-15-methyl prostaglandin E2 ( Arbaprostil) on the healing of duodenal ulcer, Gastroenterol 83: 357–363Google Scholar
  6. 6.
    Ahlquist DA, Dozois RR, Zinsmeister AR, Malagelada J-R (1983) Duodenal prostaglandin synthesis and acid load in health and in duodenal ulcer disease, Gastroenterol 82: 522–528Google Scholar
  7. 7.
    Wright JP, Young GO, Klaff LJ, Weers LA, Price SK, Marks IN (1982) Gastric mucosal prostaglandin E levels in patients with gastric ulcer disease and carcinoma, Gastroenterol 82: 263–267Google Scholar
  8. 8.
    Konturek SJ, Obtulowicz W, Kwiecien N, Oleksy J (1984) Generation of prostaglandins in gastric mucosa of patients with peptic ulcer disease: effects on non-steroidal anti-inflammatory compounds, Scand J Gastroenterol 19 (Suppl 101): 75–77Google Scholar
  9. 9.
    Schlegel W, Wenk K, Dollinger HC, Raptis S (1977) Concentrations of prostaglandin A-, E- and F-like substances in gastric mucosa of normal subjects and of patients with various gastric diseases,Clin Sei Mol Med 52: 255–258Google Scholar
  10. 10.
    McCready DR, Clark L, Cohen M (1985) Cigarette smoking reduces human gastric luminal prostaglandin E2, Gut 26: 1192–1196PubMedCrossRefGoogle Scholar
  11. 11.
    Grimes DS, Goddard J (1978) Effect of smoking on gastric emptying, Br Med J 2: 460–461PubMedCrossRefGoogle Scholar
  12. 12.
    Quimby GF, Bonnice CA, Burstein SH, Eastwood GL (1986) Active smoking depresses prostaglandin synthesis in human gastric mucosa, Ann Int Med 104: 616–619PubMedGoogle Scholar
  13. 13.
    Rachmilewitz D, Ligumsky M, Fich A, Goldin E, Eliakim A, Karmeli F (1986) Role of endogenous gastric prostanoids in the pathogenesis and therapy of duodenal ulcer. Gastroenterol 90: 963–969Google Scholar
  14. 14.
    Peterson WL, Sturdevant RAL, Franke HD, et al (1977) Healing of duodenal ulcer with an antacid regimen, N Eng J Med 297: 341–345CrossRefGoogle Scholar
  15. 15.
    Bardhan KD, Saul DM, Edwards JL et al (1979) Comparison of two doses of Cimetidine and placebo in the treatment of duodenal ulcer: a multicentre trial, Gut 20: 68–74CrossRefGoogle Scholar
  16. 16.
    Parente F, Lazzaroni M, Sangaletti O, Baroni S, Bianchi Porro G (1986) Cigarette smoking, gastric acid secretion, and serum pepsinogen 1 concentrations in duodenal ulcer patients, Gut 26: 1327–1332CrossRefGoogle Scholar
  17. 17.
    Walker V, Taylor WH (1979) Cigarette smoking, chronic peptic ulceration, and pepsin 1 secretion, Gut 20: 971–976PubMedCrossRefGoogle Scholar
  18. 18.
    Bocheneck WJ, Koronczewski R (1973) Effect of cigarette smoking on bicarbonate and volume of duodenal contents, Am J Dig Dis 729–733Google Scholar
  19. 19.
    Bynum TE, Solomon TE, Johnson LR, Jacobsen ED (1972) Inhibition of pancreatic function in man by cigarette smoking, Gut 13: 361–365PubMedCrossRefGoogle Scholar
  20. 20.
    Read NW, Grech P (1973) Effect of cigarette smoking on competence of the pylorus: preliminary study, Br Med J 2: 313–316CrossRefGoogle Scholar
  21. 21.
    Yeomans ND, Millar SJ (1980) Effect of tobacco smoke condensate on mucus, protein, and DNA synthesis in cultured antral mucosa. Aust NZ J Med 10: 590Google Scholar
  22. 22.
    Sonnenberg A, Husmert N (1982) Effect of nicotine on gastric mucosal blood flow and acid secretion, Gut 23: 532–535PubMedCrossRefGoogle Scholar
  23. 23.
    Fletcher DR, Shulkes A, Hardy KJ (1985) The effect of cigarette smoking on gastric acid secretion and gastric mucosal blood flow, Aust NZ J Med 15: 417–420CrossRefGoogle Scholar
  24. 24.
    Hillier K, Smith CL, Jewell R, Arthur MJP, Ross G (1985) Duodenal mucosa synthesis of prostaglandins in duodenal ulcer disease, Gut 26: 237–240PubMedCrossRefGoogle Scholar
  25. 25.
    Sharon P, Cohen F, Zifroni A, Karmeli F, Ligumsky M, Rachmilewitz D (1983) Prostanoid synthesis by cultured gastric and duodenal mucosa: possible role in the pathogenesis of duodenal ulcer, Scand J Gastroenterol 18: 1045–1049PubMedCrossRefGoogle Scholar
  26. 26.
    Branski D, Sharon P, Karmeli F, Rachmilewitz D (1984) Effect of Cimetidine on human gastric and duodenal prostanoid synthesis, Scand J Gastroenterol 19: 457–460PubMedGoogle Scholar
  27. 27.
    Bright-Asare P, Krejs GJ, Santangelo W, et al (1986) Treatment of duodenal ulcer with enprostil, a prostaglandin E2 analog, Am J Med 81 (2A): 59–63CrossRefGoogle Scholar
  28. 28.
    Lam S-K, Lau W-Y, Choi T-K, et al (1986) Prostaglandin E, (Misoporostol) overcomes the adverse effect of chronic cigarette smoking on duodenal ulcer healing, Dig Dis Sei 31: 68S–74SCrossRefGoogle Scholar
  29. 29.
    Thomson ABR, Navert H, Halvorsen L et al (1986) Treatment of duodenal ulcer with enprostil, a prostaglandin E2 analog, Am J Dig Dis 81 (2A): 59–63Google Scholar
  30. 30.
    Lauritsen K, Laursen LS, Havelund T, Bytzer P, Svendsen LB, Rask-Madsen J (1986) Enprostil and ranitidine in duodenal ulcer healing: double-blind comparative trial, Br Med J 292: 864–866CrossRefGoogle Scholar
  31. 31.
    Bright-Asare P, Sontag SJ, Gould RJ et al (1986) Efficacy of misoprostol (twice daily dosage) in acute healing of duodenal ulcer: a multicentre double-blind controlled trial, Dig Dis Sei 31: 63S–67SCrossRefGoogle Scholar
  32. 32.
    Rachmilewitz D, Chapman JW, Nicholson PA (1986) A multicentre international controlled comparison of two dosage regimens of misoprostol with Cimetidine in treatment of gastric ulcer in outpatients, Dig Dis Sei 31: 75S–80SCrossRefGoogle Scholar
  33. 33.
    Dammann H-G, Hüttemann W, Kalek HD, Rohner HG, Simon B (1986) Comparative clinical trial of enprostil and ranitidine in the treatment of gastric ulcer, Am J Dig Dis 81 (2A): 80–84Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1988

Authors and Affiliations

  • E. J. S. Boyd
  • K. G. Wormsley

There are no affiliations available

Personalised recommendations