Occasional gastroesophageal reflux without troublesome symptoms or complications is even more common. Treating underlying disease such as gum disease, tooth decay, or gastroesophageal reflux disease may help. Acid reflux, or gastroesophageal reflux disease, can greatly exacerbate the mouth-alcohol problem. It is also used in gastroesophageal reflux disease. Other contributing factors include nocturnal asthma, gastroesophageal reflux, and central nervous system medications. It does not appear to have an effect on gastroesophageal reflux disease. Pepsin may also cause mucosal damage during weakly acidic or non-acid gastric reflux. UDCA has been suggested to be an adequate treatment of bile reflux gastritis. Camostat is approved in Japan for the treatment of chronic pancreatitis and postoperative reflux esophagitis. Chronic cases may occur due to smoking, tuberculosis, allergies, acid reflux, rheumatoid arthritis, or sarcoidosis. Pepsin remains in the larynx following a gastric reflux event. This and other research implicates pepsin in carcinogenesis attributed to gastric reflux. Approximately 50% of horses with gastric reflux require surgery. Research to develop new pepsin-targeted therapeutic and diagnostic tools for gastric reflux is ongoing. These include vesicoureteral reflux, urethral stricture, and stenosis.