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Say it happens when the spinkter is loose. can you operate to tighten it? >> you can. limited procedures to do through scope. that's not a first resort, last resort. lifestyle is a first resort. you simply lose weight. it will improve. >> how do you know which one you have? >> it's not so much important what you really have. the fact is if you have reflux, right, short term, once in a while you may have bad food or big steak and you may have reflux, nobody cares and nobody treats it and if it becomes a chronic disease and having it twice a week then you have real gerd and issue. why does this ...

Expert in the field. but the main issue is that we are eating big portions late at night and going to bed. that puts pressure on the stomach and pushes the acid up. have three hours before you go to sleep. obesity, that will put the acid -- put the pressure up. moking, same thing. chocolate, tomato sauce, alcohol, all of this will keep the valve open and push it up. try to stay away from this -- >> oh, man, coffee, chocolate. >> he makes a great point, the acid comes up because the sphincter loosens up. >> absolutely. good to see you. >> thank you. >> coffee. >> jamie: we are not giving up our...