Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used over-the-counter pain relievers. However, they also affect the acid in your stomach, and can cause damage to your stomach and intestines. The damage to your stomach can cause painful ulcers, so avoid overusing NSAIDs or use a different pain reliever.  Common NSAIDs include aspirin, ibuprofen, naproxen, ketoprofen, and nabumetone. When using over-the-counter NSAIDs, do not use them for more than three days for fever or 10 days for pain relief. If you need long-term pain relief, talk with your doctor about other options. People over 60 and people with H. pylori co-infection are also at a higher risk of developing life-threatening ulcer complications when using NSAIDs. Being stressed out can increase the level of H. pylori bacteria in your stomach, which cause painful ulcers that are affected by the acid in your stomach. Stress can also make your symptoms worse if you already have stomach issues. Identify the stressors in your life so you can avoid them or find a way to manage them so you can lower your overall stress levels.  Set aside time for yourself to do relaxing activites such as taking a pampering bubble bath, going shopping just for fun, or taking up a new hobby. Try yoga or tai chi. Both have been found to relieve stress in clinical studies.  Try to get at least 2.5 hours of moderate physical activity every week. Exercise can decrease feelings of stress and anxiety. Talk with family or friends or join a support group to feel like you’re part of a supportive community. Smoking causes changes in the tissues of your stomach and intestines, which can cause pain and discomfort and potentially form ulcers. If you do smoke,  try quitting as soon as possible so your stomach can heal itself, which may reduce your acidity. If you’re around others who smoke, try to avoid breathing in the secondhand smoke.  Smoking increases your risk of GERD by weakening the lower esophageal sphincter (LES), the muscle at the entrance of the stomach that keeps acid from flowing back into the esophagus. Smokers have a much higher risk of frequent and chronic heartburn.  Smoking weakens your immune system and increases your risk of H. pylori infection, which increases your likelihood of developing stomach ulcers. Smoking also slows the healing of ulcers and makes them more likely to reoccur.  Smoking increases pepsin, an enzyme produced by your stomach that may harm your stomach lining in excessive amounts. It also decreases factors that help heal your stomach lining, including blood flow and mucus production. Carrying excess weight in your abdominal area puts pressure on your lower esophageal sphincter, forcing your stomach contents and stomach acid into the esophagus and causing heartburn, which is why heartburn is a common side effect of pregnancy. If you have a BMI greater than 29, losing weight may help reduce your heartburn.  Before starting any weight loss regimen, consult with your physician. If you are severely overweight (BMI equal to or greater than 40), bariatric surgery may be an option to help you reduce your weight and improve acid reflux symptoms. Talk with your doctor about whether this surgery is right for you.
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