“Common sense is not so common” –Voltaire
A recent study (E Ness-Jensen et al. Clin Gastroenterol Hepatol 2016; 14: 175-82) reviewed the literature and identified 15 original studies which met inclusion criteria regarding lifestyle interventions in gastroesophageal reflux disease (GERD).
- Weight loss lowered esophageal acid exposure in 2 RCTs: 5.6% –>3.7% and 8.0%–>5.5% and reduced reflux symptoms in prospective observational studies
- Tobacco cessation reduced reflux symptoms in normal-weight individuals in a large prospective cohort study OR 5.67
- Head-of-the-bed elevation decreased supine acid exposure from 21% to 15%.
- Early evening meals decreased supine acid exposure by 5.2% point change.
My take: With the increasing incidence of obesity, these type of lifestyle modifications need to be implemented in our teenagers with GERD. For those who want to decrease use of medications, these interventions, if emphasized with conviction, are a good first step.