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Smoking aggravates acid reflux disease
Health advice
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Just about everyone knows smoking is a significant risk factor for many health problems including cardiovascular disease, diabetes and cancer, but most don’t realize smoking can cause your esophageal sphincter to relax and stimulate stomach acid resulting in gastroesophageal reflux disease.
GERD occurs when the lower esophageal sphincter does not close properly and stomach contents leak back (or reflux) into the esophagus. The lower esophageal sphincter is a ring of muscle at the bottom of the esophagus that acts like a valve. The esophagus carries food from the mouth to the stomach and when this valve is functioning properly, food and liquids pass into the stomach but the sphincter prevents them from coming back up.
When refluxed stomach acid touches the lining of the esophagus, it causes a burning sensation in the chest or throat commonly called “heartburn.” It is called “acid indigestion” when the fluid is tasted in the back of the mouth. Heartburn every now and then is common and having it occasionally does not necessarily mean you have GERD. Heartburn that occurs more than twice a week, however, may be considered GERD, and this can eventually lead to more serious health problems.
Persistent heartburn is the most frequent symptom of GERD. Most Americans don’t associate heartburn with GERD because it is so common. Most people know that heartburn and pain are symptoms of GERD but don’t realize that there are lots of other symptoms that can occur when GERD is present. Symptoms can include hoarseness, chronic cough, asthma, laryngitis, recurrent pneumonia and ENT infections, nocturnal choking, sleep apnea, loss of dental enamel and bad breath.
A chronic disease, GERD requires treatment on a long-term basis, sometimes even after symptoms have been brought under control. Issues of daily living and compliance with long-term use of medication often need to be addressed. Various methods to effectively treat GERD range from lifestyle measures to the use of medication or surgical procedures. It is essential for individuals who suffer persistent heartburn or other chronic and recurrent symptoms of GERD to work with their physician, and to receive the most effective treatment available.
Certain foods promote or worsen symptoms of acid reflux. Some, such as citrus, tomato and coffee, directly irritate the esophagus lining. Overeating as well as going to bed within 2-3 hours of supper should be avoided since gastric distention promotes reflux. GERD suffers should also avoid late night snacks. Foods that can be associated with reflux include; citrus fruits, chocolate, drinks with caffeine, fatty and fried foods, garlic and onions, mint flavorings, spicy foods and tomato-based foods.
Weight gain, pregnancy, smoking and alcohol have also been implicated as risk factors for GERD. Reflux symptoms may often be reduced simply by elevating the head end of the bed or by using a wedge under the upper body. Other lifestyle changes include:
If you smoke, stop.
Do not drink alcohol.
Lose weight if needed.
Eat small meals.
Wear loose-fitting clothes.
Avoid lying down for three hours after a meal.
GERD is primarily treated with changes in lifestyle as well as acid suppression.

Ratcliffe works for the Coastal Health District.
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From the book 'Outliers' comes proof that good health is more than just genetics
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Friends Jim Young, left, Mike Natale, Jeff Natale and Ryan Kiernan were on Greenwich High School football team together and Jim and Mike were captains. Jim, who was the youngest in Sherry Young's family, was welcome in the homes of the other three boys who still had siblings around and grandparents near. - photo by Sherry Young
As I look back on my life and the lives of others, both personally and in the reading I have done, I am convinced of the necessity of positive human contact in our lives. We are doubly blessed when we are able to make good friends or are a part of a family where we are accepted and loved.

Malcolm Gladwell in his book Outliers tells of a time in the 1950s when Dr. Stewart Wolf met a physician who practiced in the area of Roseto, Pennsylvania. Roseto was settled by a group of Italian families from Roseto, Italy, who re-created their life again in America.

This was in the 1950s before drugs and measures to prevent heart disease became important. In their conversation the physician said, You know, Ive been practicing for 17 years. I get patients from all over, and I rarely find anyone from Roseto under the age of 65 with heart disease.

Wolf was surprised by these words as, It was impossible to be a doctor, common sense said, and not see heart disease.

Wolf enlisted the aid of a sociologist and friend John Bruhn to help him. They found, There was no suicide, no alcoholism, no drug addiction, and very little crime. They didnt have anyone on welfare. Then we looked at peptic ulcers. They didnt have any of those either. These people were dying of old age. Thats it.

They checked into diet, genetics and possibilities of something in the foothills of eastern Pennsylvania but nothing made sense.

What they found was that Rosetans visited one another, stopping to chat in Italian on the street, say, or cooking for one another in their backyards. (Researchers) learned about the extended family clans that underlay the towns social structure. They saw how many homes had three generations living under one roof and how much respect grandparents commanded. They went to Mass at Our Lady of Mount Carmel and saw the unifying and calming effect of the church. They counted 22 separate civic organizations in a town of just under 2,000 people. They picked up on the particular egalitarian ethos of the community, which discouraged the wealthy from flaunting their success and helped the unsuccessful obscure their failures.

What they found eventually convinced the medical establishment to look beyond the individual and understand the culture people are part of their friends, families and town they came from. They determined that the people we surround ourselves with and the values of the world we inhabit have a profound effect on who we are.

Likely, this study could have been done with other ethnicities. However, my family's experiences with the Italian families in Connecticut ring true to the study. Our hungry and growing sons, especially our youngest son, Jim, who was left home alone with two beady-eyed parents, all had some memorable experiences being fed and loved in the Cos Cob multigenerational families. Proof of the African proverb, It takes a village to raise a child.

We live in an age when the contact we have with people often is on the internet, and many of us live among strangers. Unless we make the effort to reach out, we will become isolated, especially as we age. The Rosetan study is proof that reaching out and communicating may be good for our health.
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