“There are many risk factors for acid reflux, including smoking, use of alcohol and hiatal hernia, according to the U.S. National Library of Medicine.”
Probably some STDs as well... And in his case probably more likely.
Never have surgery for a Hiatal Hernia, my friend almost died and still has problems with food.
I had one and my chiropractor fixed it, it hurt like hell when he pushed and pulled it, but I have never had problems since and that was over 15 years ago.