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There are a number of prescription and over-the-counter medications that can worsen GERD symptoms, like NSAIDs (ibuprofen, aspirin, naproxen, diclofenac, and more), antibiotics, potassium and iron supplements, narcotics, progesterone, sedatives, and some antidepressants

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Details Category: Smoking Object Number: 2000-39 type: tobacco credit: Harrods Limited Related Objects Cherrywood tobacco pipe Tinder pistol with incorporated candle holder on an arm protruding from the tinder well Tortoiseshell snuff box Clay tobacco pipe decorated with bust of Edward VII and Queen Alexandra Stone cigarette holder Snuff Box, England, 1771-1830

This can happen for a variety of reasons, including tobacco that has been dropped on the floor, broken up into small pieces, discolored, dirty, stems, etc