Patient Education

• 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
• Lifestyle modifications are 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)
• 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 w/ heartburn or regurgitation when recumbent
  • Avoiding recumbency for 2-3 hr postprandial
  • Avoiding large meals & decreasing fat intake
  • Avoiding late meals or skipping meals

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