Question

CF is a 48-year-old man who presents for evaluation of heartburn. He denies current tobacco use but has a history of one ppd for 15 years. He consumes a glass of wine nightly, more on the weekends. He has a sedentary job. He reports a burning feeling in his chest after eating. It is worse when he eats spicy foods or tomato sauce. He is sometimes awakened at night with these symptoms. He has tried over-the-counter antacids and histamine H2 receptor antagonists (H2RAs) with partial relief. He is on no medications regularly. His examination today is normal. An upper gastrointestinal (GI) x-ray series reveals gastroesophageal reflux.

What is the significance of HX of one ppd for 15 years?

Answer 1

Mr CF has presented with complaints of heart burn and gives a history of tobacco consumption one packet per day for 15 years .one packet consist of around 10-12 cigarettes This is a very significant history because smoking is a risk factor to develop GERD Gastroesophageal reflux disease .Smoking leads to many illness like cancers of oral,lungs .at the same time smoking will lead to Heart burn caused by GERD because tobacco or smoking loosens the spincter of esophagus which leads to food content from the stomach to be refluxed in to the esophagus.Our stomach has certain acids and enzymes which help in the metabolism and digestion of food stuffs but esophagus doesn't have any acids or enzymes to break down the food as a result of which this refluxed food can lead to esophageal irritation leading to ulcers,heart burn.

So a smoker of long time history can have heart burn because of smoking