Gastroesophageal%20reflux%20disease Patient Education
Lifestyle Modification
- Considered the 1st line of treatment
- Pregnant women who have GERD should also be offered lifestyle modification as 1st-line therapy
- 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
- Advice should be tailored to the circumstances of the individual patient:
- 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 LES pressure [eg calcium channel blockers, beta-agonists, alpha-adrenergic agonists, Theophylline, nitrates, phosphodiesterase-5 (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