Effects of transdermal nicotine on lower esophageal sphincter and esophageal motility

Digestive Diseases and Sciences
S C KadakiaR T Shaffer

Abstract

Cigarette smoking has been shown to decrease lower esophageal sphincter pressure (LESP) by 19-42%. This decrease in LESP may be due to nicotine in the cigarette smoke or substances other than nicotine. The aim of this study was to evaluate the effects of a nicotine patch on esophageal motility since nicotine patches are devoid of all toxins present in the cigarette smoke except the nicotine. Ten healthy nonsmoking volunteers underwent baseline esophageal manometry. Esophageal manometry was repeated after placing a nicotine transdermal patch (Nicotrol) designed to deliver 15 mg of nicotine per day. The parameters that were compared included LESP by rapid pull-through (LESP-RPT) and station pull-through (LESP-SPT), LES relaxation, and velocity, amplitude, and duration of esophageal contractions. Plasma nicotine and cotinine levels were measured prior to baseline manometry and after 12 hr of placing the nicotine patch, the LESP-RPT decreased by 31% from 17.4 +/- 6.1 to 12.1 +/- 3.3 (P = 0.013) and the LESP-SPT by 27% from 13.4 +/- 5.4 to 9.8 +/- 4.8 (P = 0.029) after the nicotine patch. LES relaxation was present in 100% before and after nicotine patch. There were no significant differences in velocity, duration, and amplitude of ...Continue Reading

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