Gastroenterology Search
Gastroenterology Gastroenterology
gastroesophageal%20reflux%20disease
GASTROESOPHAGEAL REFLUX DISEASE
Gastroesophageal reflux disease is a condition which results from the recurrent backflow of gastric contents into the esophagus and adjacent structures causing troublesome symptoms and/or tissue injury.
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.
Acid regurgitation is the perception of flow of refluxed gastric contents into the mouth or hypopharynx.
Heartburn is the burning sensation in the retrosternal region.

Lifestyle Modification

  • All patients should be educated regarding factors that may worsen their gastroesophageal reflux disease (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) and/or reflux (eg alcohol, coffee, chocolate, peppermint, fatty foods)
  • Avoidance of medications that lower lower esophageal sphincter (LES) pressure (eg calcium channel blockers, beta-agonists, alpha-adrenergic agonists, Theophylline, nitrates, PDE-5 inhibitors) or irritate the esophagus (eg Ferrous sulfate, nonsteroidal anti-inflammatory drugs [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
Capsule endoscopy feasible for iron deficiency anaemia diagnosis
4 days ago
The use of capsule endoscopy (CE) appears to be effective in the diagnosis of iron deficiency anaemia (IDA), yielding a 33.9-percent yield in this study, with 65.8 percent of patients undergoing further workup and 12.7 percent requiring therapeutic intervention.
Minimally invasive pancreatectomy effective for pancreatic neuroendocrine neoplasms
Tristan Manalac, 3 days ago
Minimally invasive pancreatectomy (MIP) offers a feasible alternative to open pancreatectomy (OP) for the treatment of pancreatic neuroendocrine neoplasms (PNEN), according to a recent Singapore study has found.
Managing acne in primary care
Dr. Wong Soon Tee, 21 hours ago
Acne is a common skin problem seen in primary care. Dr Wong Soon Tee of Assurance Skin Clinic at Mt Elizabeth Novena Hospital, Singapore shares his insights with Pearl Toh on how to manage acne in the primary care setting.
Doctors give PPIs a bad name, recommends discontinuation even in UGIB
Yesterday
The perception that proton pump inhibitors (PPIs) cause multiple serious adverse effects (AEs) is supported by many internists, who then recommend treatment cessation even in patients at high risk for upper gastrointestinal bleeding (UGIB), reveals a study.