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Gastroesophageal reflux into the pharynx is pathogenic in a variety of extraesophageal complications of gastroesophageal reflux disease (GERD). Intrinsic reflexes, in particular, pharyngoglottal closure reflex (PGCR) and stimulated pharyngeal swallow, can protect upper airways and block entry of gastric refluxate. To evaluate the effect of smoking on PGCR, researchers studied 10 chronic smokers and 10 matched healthy nonsmokers before and after real or simulated (with unlit cigarettes) smoking. PGCR was elicited with incremental volumes of rapid and slow water injections using an upper esophageal sleeve assembly; glottal closure function was assessed by transnasal video endoscopy; and swallowing function was monitored by electromyography.
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