Efficacy of lifestyle interventions for GERD Weight loss: - Improvement of GERD symptoms and esophageal pH - Strong recommendation for patients with BMI >25 or patients with recent weight gain Head of bed elevation: - Improved esophageal pH and symptoms - Head of bed elevation with foam wedge or blocks in patients with nocturnal GERD Avoidance of late evening meals: - Improved nocturnal gastric acidity but not symptoms - Avoid eating meals with high fat content within 2-3 h of reclining Tobacco and alcohol cessation: - No change in symptoms or esophageal pH - Not recommended to improve GERD symptoms Cessation of chocolate, caffeine, spicy foods, citrus, carbonated beverages: - No studies performed - Not routinely recommended for GERD patients. Selective elimination could be considered if patients note correlation with GERD symptoms and improvement with elimination doi: 10.1038/ajg.2012.444 #lifestyle #interventions #GERD #reflux #management #primarycare
