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A CT of the abdomen showed a hiatal hernia with thickening of the lower esophagus and edematous stomach with peri-gastric pneumoperitoneum

The onset of cartilage destruction is due to mechanical stress, which either directly damages chondrocytes or activates them to produce abnormal levels of MMPs and reactive oxygen species (ROS) responsible for cartilage breakdown and the release of microcrystals, osteochondral fragments, and products of ECM degradation into the joint cavity

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Get enough sleep: It may seem like an odd link, but studies show that sufficient sleep is critical for supporting glutathione levels