Gastroesophageal reflux disease medical therapy
|
Gastroesophageal reflux disease Microchapters |
|
Differentiating Gastroesophageal Reflux Disease from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Gastroesophageal reflux disease medical therapy On the Web |
|
American Roentgen Ray Society Images of Gastroesophageal reflux disease medical therapy |
|
Directions to Hospitals Treating Gastroesophageal reflux disease |
|
Risk calculators and risk factors for Gastroesophageal reflux disease medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Medical Therapy
Lifestyle Modifications
The rubric "lifestyle modifications" is the term physicians use when recommending non-drug GERD treatments. A 2006 review suggested that evidence for most dietary interventions is anecdotal; only weight loss and elevating the head of the bed were supported by evidence[1]. A subsequent randomized crossover study showed benefit by avoiding eating two hours before bed.[2]
Foods
Certain foods and lifestyle are considered to promote gastroesophageal reflux:
- Coffee, alcohol, and excessive amounts of Vitamin C supplements stimulate gastric acid secretion. Taking these before bedtime especially can cause evening reflux. (Although a study published in 2006 by Stanford University researchers disputes the effect of coffee, acidic, spicy foods etc. as a myth.[1])
- Antacids based on calcium carbonate (but not aluminum hydroxide) were found to actually increase the acidity of the stomach. However, all antacids reduced acidity in the lower esophagus, so the net effect on GERD symptoms may still be positive.[3].
- Foods high in fats and smoking reduce lower esophageal sphincter competence, so avoiding these tends to help. Fat also delays stomach emptying.
- Eating shortly before bedtime (For clinical purposes, this usually means 2-3 hours before going to bed).
- Large meals. Having more but smaller meals reduces GERD risk, as it means there is less food in the stomach at any one time.
- Soda or pop (regular or diet).
- Chocolate and peppermint.
- Acidic foods, such as oranges and tomatoes.
- Cruciferous vegetables: onions, cabbage, cauliflower, broccoli, spinach, brussel sprouts.
- Milk and milk-based products contain calcium and fat, and should be avoided before bedtime.
References
- ↑ 1.0 1.1 Kaltenbach T, Crockett S, Gerson LB (2006). "Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach". Arch. Intern. Med. 166 (9): 965–71. doi:10.1001/archinte.166.9.965. PMID 16682569.
- ↑ Piesman M, Hwang I, Maydonovitch C, Wong RK (2007). "Nocturnal reflux episodes following the administration of a standardized meal. Does timing matter?". Am. J. Gastroenterol. 102 (10): 2128–34. doi:10.1111/j.1572-0241.2007.01348.x. PMID 17573791.
- ↑ Decktor DL, Robinson M, Maton PN, Lanza FL, Gottlieb S. Effects of Aluminum/Magnesium Hydroxide and Calcium Carbonate on Esophageal and Gastric pH in Subjects with Heartburn. Am J Ther 1995;2:546-552. PMID 11854825.