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
- 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