gastroesophageal%20reflux%20disease
GASTROESOPHAGEAL REFLUX DISEASE
Gastroesophageal reflux disease is a disorder in which gastric contents recurrently reflux into the esophagus, causing troublesome symptoms and/or complications.
It is produced by various mechanisms such as frequent occurrence of transient relaxation of the lower esophageal sphincter or pressure abnormalities in the lower esophageal sphincter (which can be caused by hormonal and neural mediators, food, drugs and patient lifestyle).
Typical symptoms are acid regurgitation and heartburn.
Regurgitation is the perception of flow of refluxed gastric contents into the mouth or hypopharynx.
Heartburn is defined as burning sensation in the retrosternal region.

Lifestyle Modification

  • All patients should be educated regarding factors that may worsen their GERD symptoms but lifestyle modifications alone typically do not provide adequate relief for most GERD patients
  • Considered the first line of treatment
    • Pregnant women who have GERD should also be offered lifestyle modification as 1st-line therapy
  • Advice should be tailored to the circumstances of the individual patient
Lifestyle Modifications
  • Avoidance of foods/drinks that may precipitate heartburn (eg spicy foods, onion, tomato-based products, citrus, carbonated drinks)
  • Avoidance of food/drinks that may precipitate reflux (eg alcohol, coffee, chocolate, peppermint, fatty foods)
  • Avoidance of medications that lower LES pressure (eg calcium channel blockers, beta-agonists, alpha-adrenergic agonists, Theophylline, nitrates, PDE-5 inhibitors) or irritate the esophagus (eg Ferrous sulfate, NSAIDs, bisphosphonates)
  • Adoption of behaviors that will help reduce esophageal acid exposure
    • Weight loss should be advised for obese or overweight patients
    • Smoking cessation
    • Elevation of the head of the bed for patients who are troubled with heartburn or regurgitation when recumbent
    • Avoiding recumbency for 2-3 hours postprandial
    • Avoiding large meals and decreasing fat intake
    • Avoiding late meals or skipping meals
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Gastroenterology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
27 Jan 2018
There is an over-representation of women in published reports of celecoxib drug-induced liver injury (DILI), according to a recent study. Latency has been shown to be short (<3 months) in most patients, but some of them may present with DILI after prolonged use of celecoxib.
22 Mar 2016
A recent study showed that routine use of alpha galactosidase (AG) has no benefit in irritable bowel syndrome (IBS) patients.
15 Nov 2017
Both hatha yoga and a low-FODMAP (Fermentable, Oligo-, Di-, Monosaccharides and Polyol) diet can alleviate gastrointestinal symptoms, as well as improve a range of other psychological and physiological health parameters, in patients with irritable bowel syndrome (IBS), a study has shown.
Rachel Soon, 14 Dec 2016

More well-designed studies are needed to confirm the benefits of various probiotics currently promoted for gut health, according to experts.