Lifestyle Management of Gastroesophageal Reflux Disease: Evidence-Based Approaches to Improve Patient Care

Gastroesophageal reflux disease (GERD) is one of the most common diseases of the esophagus, with an estimated prevalence in westernized countries approaching 33%.1 It is defined by troublesome symptoms related to increased esophageal acid exposure and can be further classified by presence or absence of mucosal disease (ie, reflux esophagitis).2 Symptoms often occur in the setting of an incompetent esophagogastric junction secondary to inadequate lower esophageal sphincter (LES) pressures, increase in transient LES relaxations (TLESR), or anatomical abnormalities such as hiatal hernia. Symptoms can also occur because of inadequate clearance of refluxed stomach contents due to ineffective peristalsis. Although gross anatomic or motility related abnormalities are best treated by endoscopic and/or surgical procedures, lifestyle interventions including smoking cessation, alterations in diet, eating patterns, and weight, and changes in sleeping position may improve overall symptom burden and can be used in conjunction with acid suppressing medications.3 The following is a review of these lifestyle interventions including relevant supporting literature and practical approaches to patient care.