Vaping-associated mechanisms in the development of gastroesophageal reflux disease

BACKGROUND: There is compelling evidence of the negative impact of vaping on the respiratory and cardiovascular systems. However, its effects on the gastrointestinal tract remain understudied.

AIM: The study aimed to assess the impact of vaping on the functional state of the gastroesophageal zone in healthy individuals compared with patients with gastroesophageal reflux disease (GERD).

METHODS: The study included 90 participants divided into three groups of 30 individuals each. Group 1 consisted of individuals with no gastrointestinal disorders who had been regularly vaping for more than 12 months. Group 2 included patients with GERD. Group 3 (control group) comprised healthy individuals with no harmful habits. Clinical manifestations of reflux syndrome were assessed using validated questionnaires. Participants underwent 24-hour impedance-pH monitoring, and serum levels of gastrin and motilin were measured. Statistical analysis was performed using the Kruskal–Wallis test and Dunn test. Fisher exact test was used for comparing qualitative variables, whereas Spearman correlation coefficient was applied for dependency assessment. The significance threshold was set at p < 0.05.

RESULTS: In Group 2 (GERD), a low pH level in the lower esophagus and a high daily frequency of all types of reflux episodes were recorded. Compared with the control group, patients in group 2 had lower serum motilin levels (83.2 [56.9; 99.3] pg/mL vs 189.7 [117.6; 362.3] pg/mL, p = 0.001). Vapers had a more pronounced reflux syndrome compared with healthy individuals, with an increased daily number of acidic (54 [39.5; 71] vs 21.5 [18; 28.8], p = 0.001) and weakly acidic (7.5 [4.3; 9.8] vs 2 [1; 3], p = 0.001) reflux episodes, along with a decrease in esophageal pH levels (4.7 [4.1; 5.9] vs 6.7 [6.2; 6.8], p = 0.001).

CONCLUSION: Vaping is associated with an increased number of gastroesophageal reflux episodes, likely due to the suppression of lower esophageal sphincter motility, and may contribute to the development of GERD.