Materiały źródłowe

• #1 Acid Reflux/GERD | ACG

  https://gi.org/topics/acid-reflux/

  GERD can result in serious complications including severe chest pain that can mimic a heart attack, esophageal stricture (a narrowing or obstruction of the esophagus), bleeding, or a pre-cancerous change in the lining of the esophagus called Barrett’s esophagus. […] Treatment should be designed to eliminate symptoms, heal irritation of the esophagus and prevent the long-term complications of GERD. In most patients outside of significant lifestyle changes such as weight loss, GERD is a chronic disease. As such, long-term maintenance treatment to control symptoms and prevent complications may be necessary. […] In order to decrease the amount of gastric contents that reach the esophagus, certain simple guidelines should be followed: Raise the Head of the Bed. Use an under-mattress foam wedge to elevate the head about 6-10 inches. Pillows are not an effective alternative for elevating the head in preventing reflux.

• #2 Managing GERD: How to prevent acid reflux and GERD symptoms – UChicago Medicine

  https://www.uchicagomedicine.org/forefront/gastrointestinal-articles/2023/december/managing-gerd-how-to-prevent-acid-reflux-and-gerd-symptoms

  GERD is a common digestive disorder that occurs when stomach acid flows back into the esophagus the tube connecting the mouth and stomach and it can result in acid reflux symptoms like heartburn. […] Family gatherings and social dining can be stressful for people with GERD. They need to be careful when indulging in things like sweet treats or alcohol at parties. […] Here are six tips for enjoying yourself while managing GERD symptoms. […] Eat slowly, and avoid overeating. Research shows that rapid food intake produces more GERD episodes than when people eat slower. Eating slowly allows your body time to feel full, which will decrease your chances of overeating. Overeating puts pressure on the lower esophageal sphincter muscle. […] Eat at least 1-2 hours before bed. Its more difficult for your food to digest when youre lying down, so eating earlier and staying upright will allow your food time to break down.

• #3 Gastroesophageal Reflux Disease (GERD) | UCI Health | Orange County, CA

  https://www.ucihealth.org/medical-services/esophageal-disease/gerd

  Gastroesophageal reflux disease (GERD) affects millions of people each year, causing chronic heartburn and painful acid regurgitation. […] Early intervention can stop or even reverse the disease cycle. […] Based on the results, your doctor may recommend lifestyle changes, medications, or possibly procedures or surgery. […] Once you’re diagnosed with GERD, diet and lifestyle changes are usually recommended to help reduce pain and heartburn. These include: losing weight, eating smaller, slower meals, avoiding trigger foods and drinks, staying upright after meals, quitting smoking, raising the head of your bed. […] Our GERD experts also pioneered cTIF, a cutting-edge procedure that combines laparoscopic hiatal hernia repair with TIF in one session to fix the root cause of your GERD. […] GERD can raise your risk of esophageal cancer, which is why our team takes a comprehensive approach to address all factors and help ensure the best long-term results for you.

• #4 GERD (Acid Reflux): Symptoms, Treatment, Causes and More

  https://www.healthline.com/health/gerd

  To manage and relieve symptoms of GERD, certain home remedies and lifestyle habits may help, including: […] If lifestyle strategies alone don’t help treat GERD, a doctor might prescribe medications to decrease your stomach acid secretion, since acid reflux is a common manifestation of GERD. […] In most cases, lifestyle strategies and medications are enough to prevent and relieve symptoms of GERD. […] To lower your chances of complications, it’s important to take the steps to prevent, manage, and treat symptoms of GERD. […] Following the advice of a healthcare professional may help you heal GERD permanently or manage symptoms. Strategies may include dietary changes, medications, and lifestyle modifications. […] If these don’t help, you may need surgery.

• #5 How Can I Prevent Heartburn and Other Symptoms of GERD?

  https://www.webmd.com/heartburn-gerd/understanding-gerd-prevention

  Get on a GERD Diet […] A key way to prevent it is to make tweaks to your diet and the way you eat. […] Have small, frequent meals. […] Avoid trigger foods. […] Cut back on alcohol, tea, coffee, and carbonated drinks. […] Tweak Your Bedtime Routine […] Don’t eat before bedtime. […] Prop up the head of your bed 6 to 10 inches. […] Stop Smoking […] You can also prevent heartburn if you ditch cigarettes, since smoking can trigger GERD symptoms. […] Lose Weight if You Need To […] Obesity has been linked to GERD. […] Avoid Certain Medications […] Some over-the-counter pain drugs can make GERD worse, including aspirin, ibuprofen, and naproxen. […] Other Tips to Prevent GERD […] Relieve stress: See if yoga, meditation, or tai chi can cut your symptoms. […] Chew gum after meals: You’ll make more saliva, which helps neutralize heartburn-causing acid. […] Wear loose clothing: Tight clothing, especially around your stomach, can push stomach acid upward.

• #6 Gastroesophageal Reflux Disease | University of Utah Health

  https://healthcare.utah.edu/gi/conditions/gastroesophageal-reflux-disease-gerd

  How to Prevent GERD […] Some tips and behavioral changes may help you prevent episodes of reflux: […] Avoid lying down for at least three to four hours after eating. […] Eat small meals throughout the day. […] Elevate your head 4-6 inches when you sleep. […] Maintain a healthy body weight. […] Quit smoking.

• #7 Acid Reflux & GERD: Symptoms, What It Is, Causes, Treatment

  https://my.clevelandclinic.org/health/diseases/17019-acid-reflux-gerd

  Some people find they can reduce acid reflux with lifestyle adjustments, like changing their eating habits, reducing alcohol and tobacco and losing weight. Healthcare providers encourage this approach. […] If you have severe GERD or it causes complications that medicine can’t help, you might need surgery. But surgery is usually minor and effective. It’s worth treating GERD to prevent its complications. […] To help manage acid reflux at home, try: Eating smaller meals. Larger meals expand your stomach and put pressure on your LES. Smaller meals digest faster and don’t stimulate your stomach to produce so much acid. […] Quitting smoking and drinking. Both tobacco and alcohol weaken your LES. They also affect your stomach, making it more acidic and slowing your digestion time. […] If you have acid reflux frequently, talk to a healthcare provider. It’s important to find out how it’s affecting your body. GERD isn’t just an inconvenience – it can do real harm. It’s also very treatable.

• #8 Gastroesophageal Reflux Disease (GERD) – Harvard Health

  https://www.health.harvard.edu/a_to_z/gastroesophageal-reflux-disease-gerd-a-to-z

  Eat smaller, more frequent meals. […] Do not lie down after eating. […] Do not eat during the three to four hours before you go to bed. […] If you smoke, quit. […] Avoid drinking alcohol. It loosens the esophageal sphincter. […] Lose weight if you are obese. Obesity can make it harder for the esophageal sphincter to stay closed. […] Avoid wearing tight-fitting garments. Increased pressure on the abdomen can open the esophageal sphincter. […] Use lozenges or gum to keep producing saliva.

• #9 Patient education: Gastroesophageal reflux disease in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/gastroesophageal-reflux-disease-in-adults-beyond-the-basics

  While evidence is limited, other changes also sometimes seem to help, such as: […] Avoiding late meals – Lying down with a full stomach may increase the risk of acid reflux. By planning meals for at least two to three hours before bedtime, symptoms may be reduced. This is especially true for people with nighttime reflux. […] Wearing loose, comfortable clothing – At minimum, tight-fitting clothing can increase discomfort, but it may also increase pressure in the abdomen, promoting hiatus hernia and forcing stomach contents into the esophagus. […] Mild symptoms – In addition to lifestyle changes, the initial treatment of mild GERD includes the use of nonprescription antacids or histamine receptor antagonists. […] Moderate to severe symptoms – People with more severe or frequent symptoms, complications related to GERD, or mild symptoms that have not responded to the above medications usually require treatment with a medication called a proton pump inhibitor (PPI). Lifestyle changes can help as well.

• #10 Gastroesophageal Reflux Disease (GERD) | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/patient-education/gastroesophageal-reflux-disease-gerd

  The goal of treatment for GERD is to reduce your symptoms. Most people feel better with medicine and lifestyle changes. […] Here are some ways you can reduce your GERD symptoms: […] Do not eat large meals. Eat smaller meals more often. This will allow you to eat the same amount of food, but in portions that are easier to digest. […] Do not lie down for at least 2 to 3 hours after eating. […] Avoid late-night snacks. […] Avoid some foods, such as: […] Avoid some drinks, such as: […] Take antacids (medicine that relieves the acid in your stomach) or sit upright to reduce heartburn. […] Do not smoke cigarettes or use other tobacco products. […] Use blocks to raise the head of your bed or sleep on a wedge pillow to raise your upper torso. This can help with symptoms at night. […] Avoid putting pressure on your abdomen. […] Prevent or manage constipation. […] Maintain a healthy body weight through diet and physical activity. […] Take any medicine your doctor prescribes you as instructed.

• #11 GERD: Symptoms, Causes, Treatments, Remedies for Relief

  https://www.webmd.com/heartburn-gerd/reflux-disease-gerd-1

  You can make changes in your lifestyle and habits to help with your GERD and its symptoms. Some ideas include: […] Avoid food and beverage triggers. Stay away from foods that can relax the LES, including chocolate, peppermint, fatty foods, caffeine, and alcoholic beverages. You should also avoid foods and beverages that can irritate a damaged esophageal lining if they cause symptoms, such as citrus fruits and juices, tomato products, and pepper. […] Eat smaller servings. Eating smaller portions at mealtime may also help control symptoms. Also, eating meals at least 2 to 3 hours before bedtime allows the acid in your stomach to go down and your stomach to partially empty. […] Stop smoking. Cigarette smoking weakens the LES. Stopping smoking is important to reduce GERD symptoms. […] Elevate your head. Raising the head of your bed on 6-inch blocks or sleeping on a specially designed wedge lets gravity lessen the reflux of stomach contents into your esophagus. […] Stay at a healthy weight. Being overweight often worsens symptoms. Many overweight people find relief when they lose weight. […] Wear loose clothes. Clothes that squeeze your waist put pressure on your belly and the lower part of your esophagus.

• #12 Managing GERD: How to prevent acid reflux and GERD symptoms – UChicago Medicine

  https://www.uchicagomedicine.org/forefront/gastrointestinal-articles/2023/december/managing-gerd-how-to-prevent-acid-reflux-and-gerd-symptoms

  Minimize carbonated beverages and alcohol. Drink more water. Carbonated beverages and alcohol can cause relaxation of the LES muscle and trigger GERD. If you drink more water, it will clear the esophagus and reduce acid reflux. […] Avoid the triggers that give you GERD symptoms. While everyone may have different triggers, a few of the common foods and drinks that can lead to a GERD episode are: Garlic, Raw onions, Chocolate, Red wine, Peppermint, Citrus fruits. […] Keep your preferred antacid on standby. Prepare for a potential GERD episode by keeping your over-the-counter antacids or medicine prescribed by your doctor handy.

• #13 Gastroesophageal reflux disease (GERD) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gerd/diagnosis-treatment/drc-20361959

  Don’t lie down after a meal. Wait at least three hours after eating before lying down or going to bed. […] Eat food slowly and chew thoroughly. Put down your fork after every bite and pick it up again once you have chewed and swallowed that bite. […] Don’t consume foods and drinks that trigger reflux. Common triggers include alcohol, chocolate, caffeine, fatty foods or peppermint. […] Don’t wear tight-fitting clothing. Clothes that fit tightly around the waist put pressure on the abdomen and the lower esophageal sphincter.

• #14 GERD Diet: Foods to avoid, what to eat, and plans for acid reflux

  https://www.medicalnewstoday.com/articles/314690

  In 2022 guidelines for diagnosing and managing GERD, the American College of Gastroenterology suggests avoiding trigger foods to help manage GERD symptoms. However, they also state that there is little evidence to support this recommendation. […] Maintaining a moderate weight and keeping the head raised during sleep can minimize the symptoms of GERD. Other lifestyle changes that may reduce symptoms include quitting smoking, eating smaller meals, and not lying down for at least 2-3 hours after a meal.

• #15 GERD Diet: Foods to avoid, what to eat, and plans for acid reflux

  https://www.medicalnewstoday.com/articles/314690

  A person with acid reflux may benefit from avoiding certain foods that worsen their symptoms, such as spices and fizzy drinks. Those who follow a diet that is high in whole grains, fruits, and vegetables may find their symptoms improve. […] Avoiding trigger foods and following other dietary tips may relieve the symptoms of GERD. […] Although no specific foods can cure GERD, some might actively improve symptoms. […] A 2021 review suggests that certain foods, such as fruits and vegetables, are associated with lower risk of GERD. […] A 2016 study found that following the Mediterranean diet, which is rich in fruits, vegetables, whole grains, and unsaturated fats, was linked with a lower risk of GERD. […] Experts recommend following a Mediterranean diet or a similar dietary pattern rich in fruit, vegetables, and whole grains to reduce GERD symptoms.

• #16 How Can I Prevent Heartburn and Other Symptoms of GERD?

  https://www.webmd.com/heartburn-gerd/understanding-gerd-prevention

  Get on a GERD Diet […] A key way to prevent it is to make tweaks to your diet and the way you eat. […] Have small, frequent meals. […] Avoid trigger foods. […] Cut back on alcohol, tea, coffee, and carbonated drinks. […] Tweak Your Bedtime Routine […] Don’t eat before bedtime. […] Prop up the head of your bed 6 to 10 inches. […] Stop Smoking […] You can also prevent heartburn if you ditch cigarettes, since smoking can trigger GERD symptoms. […] Lose Weight if You Need To […] Obesity has been linked to GERD. […] Avoid Certain Medications […] Some over-the-counter pain drugs can make GERD worse, including aspirin, ibuprofen, and naproxen. […] Other Tips to Prevent GERD […] Relieve stress: See if yoga, meditation, or tai chi can cut your symptoms. […] Chew gum after meals: You’ll make more saliva, which helps neutralize heartburn-causing acid. […] Wear loose clothing: Tight clothing, especially around your stomach, can push stomach acid upward.

• #17 Gastroesophageal reflux disease (GERD) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gerd/diagnosis-treatment/drc-20361959

  Lifestyle changes may help reduce the frequency of acid reflux. Try to: […] Maintain a healthy weight. Excess pounds put pressure on the abdomen, pushing up the stomach and causing acid to reflux into the esophagus. […] Stop smoking. Smoking decreases the lower esophageal sphincter’s ability to function properly. […] Elevate the head of your bed. If you regularly experience heartburn while trying to sleep, place wood or cement blocks under the feet at the head end of your bed. Raise the head end by 6 to 9 inches. If you can’t elevate your bed, you can insert a wedge between your mattress and box spring to elevate your body from the waist up. Raising your head with additional pillows isn’t effective. […] Start on your left side. When you go to bed, start by lying on your left side to help make it less likely to have reflux.

• #18 GERD Treatment Options and Prevention | Banner Health

  https://www.bannerhealth.com/services/gastroenterology/treatment/gerd/gerd-treatment

  There are steps you can take to manage gastroesophageal reflux disease (GERD) effectively. Your doctor may recommend lifestyle changes and medication to get your symptoms under control. If those steps dont give you enough relief, surgery may be an option. […] You can make lifestyle changes for GERD prevention. Try these daily acid reflux management tips: […] Avoid trigger foods: Foods to avoid for GERD may include spicy, acidic, citrus or fatty foods, as well as chocolate, mint, tomatoes (or tomato sauce) and caffeine. […] Eat smaller meals throughout the day instead of large, heavy meals: Smaller meals can help keep your stomach from being overly full, which can cause acid reflux. […] Lose weight if you are overweight or obese: Weight loss can help, since losing weight will lower the pressure on your stomach.

• #19 GERD: Symptoms, Causes, Treatments, Remedies for Relief

  https://www.webmd.com/heartburn-gerd/reflux-disease-gerd-1

  You can make changes in your lifestyle and habits to help with your GERD and its symptoms. Some ideas include: […] Avoid food and beverage triggers. Stay away from foods that can relax the LES, including chocolate, peppermint, fatty foods, caffeine, and alcoholic beverages. You should also avoid foods and beverages that can irritate a damaged esophageal lining if they cause symptoms, such as citrus fruits and juices, tomato products, and pepper. […] Eat smaller servings. Eating smaller portions at mealtime may also help control symptoms. Also, eating meals at least 2 to 3 hours before bedtime allows the acid in your stomach to go down and your stomach to partially empty. […] Stop smoking. Cigarette smoking weakens the LES. Stopping smoking is important to reduce GERD symptoms. […] Elevate your head. Raising the head of your bed on 6-inch blocks or sleeping on a specially designed wedge lets gravity lessen the reflux of stomach contents into your esophagus. […] Stay at a healthy weight. Being overweight often worsens symptoms. Many overweight people find relief when they lose weight. […] Wear loose clothes. Clothes that squeeze your waist put pressure on your belly and the lower part of your esophagus.

• #20 Patient education: Gastroesophageal reflux disease in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/gastroesophageal-reflux-disease-in-adults-beyond-the-basics

  Obesity – People who are obese or overweight have an increased risk of GERD and hiatal hernia. While the reasons for this are not completely understood, it is partially related to increased pressure in the abdomen. […] Pregnancy – Many women experience acid reflux during pregnancy. This usually resolves after delivery, and complications are rare. […] Lifestyle factors and medications – Some foods (including fatty foods, chocolate, and peppermint), caffeine, alcohol, and cigarette smoking can all exacerbate acid reflux and GERD. Certain medications also increase the risk. […] GERD TREATMENT […] GERD treatment is adjusted to match the frequency and severity of GERD symptoms and/or complications. […] Lifestyle changes – Certain lifestyle and dietary changes can often help relieve symptoms of GERD. If you have mild symptoms, you can try these approaches before seeking medical attention. If your symptoms are more serious, it’s a good idea to talk to your health care provider before making any changes, so they can advise you on how to incorporate these approaches into your treatment plan.

• #21 GERD: A practical approach | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/4/223

  Gastroesophageal reflux disease (GERD) is mainly a clinical diagnosis based on typical symptoms of heartburn and acid regurgitation. Current guidelines indicate that patients with typical symptoms should first try a proton pump inhibitor (PPI). If reflux symptoms persist after 8 weeks on a PPI, endoscopy of the esophagus is recommended, with biopsies taken to rule out eosinophilic esophagitis. This review discusses the evidence for different medical, endoscopic, and surgical therapies and presents a management algorithm. […] Lifestyle modifications are the first option for most patients. […] Weight loss can help reduce and eliminate GERD symptoms. A prospective cohort study found that 81% of obese patients who completed a structured weight loss program had a reduction in symptoms, and 65% had complete resolution of symptoms.

• #22 Management of gastroesophageal reflux disease (GERD) – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/management-of-gastroesophageal-reflux-disease-gerd/

  1. AGA recommends weight loss should be advised for overweight or obese patients with esophageal GERD syndromes. […] 2. AGA recommends elevation of the head of the bed for selected patients who are troubled with heartburn or regurgitation when recumbent. Other lifestyle modifications including, but not limited to, avoiding late meals, avoiding specific foods or avoiding specific activities should be tailored to the circumstances of the individual patient. […] 3. AGA strongly recommends antisecretory drugs for the treatment of patients with esophageal GERD syndromes (healing esophagitis and symptomatic relief). In these uses, proton pump inhibitors (PPIs) are more effective than histamine2 receptor antagonists (H2RAs), which are more effective than placebo. […] 4. AGA recommends twice-daily PPI therapy for patients with an esophageal syndrome with an inadequate symptom response to once-daily PPI therapy.

• #23 Acid Reflux/GERD | ACG

  https://gi.org/topics/acid-reflux/

  GERD can result in serious complications including severe chest pain that can mimic a heart attack, esophageal stricture (a narrowing or obstruction of the esophagus), bleeding, or a pre-cancerous change in the lining of the esophagus called Barrett’s esophagus. […] Treatment should be designed to eliminate symptoms, heal irritation of the esophagus and prevent the long-term complications of GERD. In most patients outside of significant lifestyle changes such as weight loss, GERD is a chronic disease. As such, long-term maintenance treatment to control symptoms and prevent complications may be necessary. […] In order to decrease the amount of gastric contents that reach the esophagus, certain simple guidelines should be followed: Raise the Head of the Bed. Use an under-mattress foam wedge to elevate the head about 6-10 inches. Pillows are not an effective alternative for elevating the head in preventing reflux.

• #24 How to Prevent Acid Reflux and Heartburn

  https://www.healthline.com/health/gerd/preventing-heartburn

  Mild cases of acid reflux can often be prevented by adopting a few lifestyle changes, such as avoiding certain foods or not lying down immediately after a meal. […] If you regularly experience acid reflux, certain lifestyle and dietary changes may help. […] Occasional or mild cases of acid reflux can usually be prevented by adopting a few lifestyle changes. […] Sleeping on your left side may help to reduce acid reflux symptoms at night. […] A 2021 systematic review examined existing research suggesting that elevating your head while sleeping may help reduce acid reflux symptoms. […] If you have excess belly fat, the pressure in your abdomen may cause your lower esophageal sphincter to be pushed upward, away from the support of your diaphragm. […] Smoking also lowers the pressure in the lower esophageal sphincter, which can cause coughing and acid reflux. Research shows that quitting smoking can reduce the severity of your acid reflux or GERD.

• #25 Gastroesophageal reflux disease (GERD) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gerd/diagnosis-treatment/drc-20361959

  Lifestyle changes may help reduce the frequency of acid reflux. Try to: […] Maintain a healthy weight. Excess pounds put pressure on the abdomen, pushing up the stomach and causing acid to reflux into the esophagus. […] Stop smoking. Smoking decreases the lower esophageal sphincter’s ability to function properly. […] Elevate the head of your bed. If you regularly experience heartburn while trying to sleep, place wood or cement blocks under the feet at the head end of your bed. Raise the head end by 6 to 9 inches. If you can’t elevate your bed, you can insert a wedge between your mattress and box spring to elevate your body from the waist up. Raising your head with additional pillows isn’t effective. […] Start on your left side. When you go to bed, start by lying on your left side to help make it less likely to have reflux.

• #26

• #27 Gastroesophageal Reflux Disease (GERD) – Digestive Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/digestive-disorders/esophageal-and-swallowing-disorders/gastroesophageal-reflux-disease-gerd

  Several measures may be taken to relieve gastroesophageal reflux: […] Raising the head of the bed about 6 inches (about 15 centimeters) by placing 6- to 8-inch (about 15- to 20-centimeter) blocks under the legs at the head of the bed, by using a wedge pillow, or by placing a wedge under the mattress can help prevent acid from flowing into the esophagus as a person sleeps. […] Medications that cause symptoms should be avoided, as should smoking. […] Caffeine, alcohol, fatty foods, chocolate, acid-containing beverages such as orange juice, cola drinks, vinegar-based salad dressings, and other substances that strongly stimulate the stomach to produce acid or that delay stomach emptying should be avoided as well. People should avoid eating 3 hours before bedtime. […] People who are overweight and those who have gained weight recently should lose weight.

• #28 Gastroesophageal reflux disease (GERD) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gerd/diagnosis-treatment/drc-20361959

  Lifestyle changes may help reduce the frequency of acid reflux. Try to: […] Maintain a healthy weight. Excess pounds put pressure on the abdomen, pushing up the stomach and causing acid to reflux into the esophagus. […] Stop smoking. Smoking decreases the lower esophageal sphincter’s ability to function properly. […] Elevate the head of your bed. If you regularly experience heartburn while trying to sleep, place wood or cement blocks under the feet at the head end of your bed. Raise the head end by 6 to 9 inches. If you can’t elevate your bed, you can insert a wedge between your mattress and box spring to elevate your body from the waist up. Raising your head with additional pillows isn’t effective. […] Start on your left side. When you go to bed, start by lying on your left side to help make it less likely to have reflux.

• #29 Patient education: Gastroesophageal reflux disease in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/gastroesophageal-reflux-disease-in-adults-beyond-the-basics

  The following lifestyle changes are often recommended: […] Losing weight (if you are overweight or have recently gained weight) – Losing weight may help people reduce acid reflux. In addition, weight loss has a number of other health benefits, including a decreased risk of type 2 diabetes and heart disease. […] Raising the head of your bed six to eight inches – Although most people only have heartburn during the two- to three-hour period after meals, some wake up at night with heartburn. People with nighttime heartburn can elevate the head of their bed, which raises the head and shoulders higher than the stomach, allowing gravity to reduce acid reflux and aid in clearing what reflux does occur. […] Sleep on your left side – Again, although most people only have heartburn during the two- to three-hour period after meals, people with nighttime heartburn can reduce this by laying on their left side during sleep. This positions the stomach fluid away from the upper right side of the stomach where the esophagus connects, making it harder for reflux to occur.

• #30 Gastroesophageal reflux disease (GERD) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gerd/diagnosis-treatment/drc-20361959

  Lifestyle changes may help reduce the frequency of acid reflux. Try to: […] Maintain a healthy weight. Excess pounds put pressure on the abdomen, pushing up the stomach and causing acid to reflux into the esophagus. […] Stop smoking. Smoking decreases the lower esophageal sphincter’s ability to function properly. […] Elevate the head of your bed. If you regularly experience heartburn while trying to sleep, place wood or cement blocks under the feet at the head end of your bed. Raise the head end by 6 to 9 inches. If you can’t elevate your bed, you can insert a wedge between your mattress and box spring to elevate your body from the waist up. Raising your head with additional pillows isn’t effective. […] Start on your left side. When you go to bed, start by lying on your left side to help make it less likely to have reflux.

• #31 How to Prevent Acid Reflux and Heartburn

  https://www.healthline.com/health/gerd/preventing-heartburn

  Mild cases of acid reflux can often be prevented by adopting a few lifestyle changes, such as avoiding certain foods or not lying down immediately after a meal. […] If you regularly experience acid reflux, certain lifestyle and dietary changes may help. […] Occasional or mild cases of acid reflux can usually be prevented by adopting a few lifestyle changes. […] Sleeping on your left side may help to reduce acid reflux symptoms at night. […] A 2021 systematic review examined existing research suggesting that elevating your head while sleeping may help reduce acid reflux symptoms. […] If you have excess belly fat, the pressure in your abdomen may cause your lower esophageal sphincter to be pushed upward, away from the support of your diaphragm. […] Smoking also lowers the pressure in the lower esophageal sphincter, which can cause coughing and acid reflux. Research shows that quitting smoking can reduce the severity of your acid reflux or GERD.

• #32

  https://journals.lww.com/ajg/fulltext/2022/01000/acg_clinical_guideline_for_the_diagnosis_and.14.aspx

  We suggest elevating head of bed for nighttime GERD symptoms (conditional recommendation, low level of evidence). […] We recommend treatment with PPIs over treatment with histamine-2-receptor antagonists (H2RA) for healing EE (strong recommendation, high level of evidence). […] We recommend treatment with PPIs over H2RA for maintenance of healing from EE (strong recommendation, moderate level of evidence). […] We recommend PPI administration 30-60 minutes before a meal rather than at bedtime for GERD symptom control (strong recommendation, moderate level of evidence). […] For patients with GERD who do not have EE or Barrett’s esophagus, and whose symptoms have resolved with PPI therapy, an attempt should be made to discontinue PPIs or to switch to on-demand therapy in which PPIs are taken only when symptoms occur and discontinued when they are relieved (conditional recommendation, low level of evidence).

• #33 Acid Reflux & GERD: Symptoms, What It Is, Causes, Treatment

  https://my.clevelandclinic.org/health/diseases/17019-acid-reflux-gerd

  Some people find they can reduce acid reflux with lifestyle adjustments, like changing their eating habits, reducing alcohol and tobacco and losing weight. Healthcare providers encourage this approach. […] If you have severe GERD or it causes complications that medicine can’t help, you might need surgery. But surgery is usually minor and effective. It’s worth treating GERD to prevent its complications. […] To help manage acid reflux at home, try: Eating smaller meals. Larger meals expand your stomach and put pressure on your LES. Smaller meals digest faster and don’t stimulate your stomach to produce so much acid. […] Quitting smoking and drinking. Both tobacco and alcohol weaken your LES. They also affect your stomach, making it more acidic and slowing your digestion time. […] If you have acid reflux frequently, talk to a healthcare provider. It’s important to find out how it’s affecting your body. GERD isn’t just an inconvenience – it can do real harm. It’s also very treatable.

• #34 Gastroesophageal Reflux (GER) in Kids and Teens (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/gerd-reflux.html

  Avoid tobacco smoke, which can make reflux worse. Don’t let anyone smoke near your child. If your teen smokes, they should stop. […] If your child is older and reflux happens at night, raise the head of their bed 6-8 inches. […] Rarely, medical treatment alone doesn’t help enough. Then, a surgical procedure called fundoplication might be an option.

• #35 Gastroesophageal reflux disease (GERD) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gerd/diagnosis-treatment/drc-20361959

  Lifestyle changes may help reduce the frequency of acid reflux. Try to: […] Maintain a healthy weight. Excess pounds put pressure on the abdomen, pushing up the stomach and causing acid to reflux into the esophagus. […] Stop smoking. Smoking decreases the lower esophageal sphincter’s ability to function properly. […] Elevate the head of your bed. If you regularly experience heartburn while trying to sleep, place wood or cement blocks under the feet at the head end of your bed. Raise the head end by 6 to 9 inches. If you can’t elevate your bed, you can insert a wedge between your mattress and box spring to elevate your body from the waist up. Raising your head with additional pillows isn’t effective. […] Start on your left side. When you go to bed, start by lying on your left side to help make it less likely to have reflux.

• #36 Patient education: Gastroesophageal reflux disease in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/gastroesophageal-reflux-disease-in-adults-beyond-the-basics

  Avoiding foods that trigger symptoms – Some foods also cause relaxation of the lower esophageal sphincter, which can lead to acid reflux. Excessive caffeine, chocolate, alcohol, peppermint, and fatty foods may cause bothersome acid reflux in some people. If you notice that your symptoms are worse after you have certain foods or beverages (trigger foods), it’s reasonable to limit or avoid these things. […] Quitting smoking – Saliva helps to neutralize refluxed acid, and smoking reduces the amount of saliva in the mouth and throat. Smoking also lowers the pressure in the lower esophageal sphincter and provokes coughing, causing frequent episodes of acid reflux in the esophagus. In addition to having many other health benefits, quitting smoking can reduce or eliminate symptoms of mild reflux.

• #37 Patient education: Gastroesophageal reflux disease in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/gastroesophageal-reflux-disease-in-adults-beyond-the-basics

  Avoiding foods that trigger symptoms – Some foods also cause relaxation of the lower esophageal sphincter, which can lead to acid reflux. Excessive caffeine, chocolate, alcohol, peppermint, and fatty foods may cause bothersome acid reflux in some people. If you notice that your symptoms are worse after you have certain foods or beverages (trigger foods), it’s reasonable to limit or avoid these things. […] Quitting smoking – Saliva helps to neutralize refluxed acid, and smoking reduces the amount of saliva in the mouth and throat. Smoking also lowers the pressure in the lower esophageal sphincter and provokes coughing, causing frequent episodes of acid reflux in the esophagus. In addition to having many other health benefits, quitting smoking can reduce or eliminate symptoms of mild reflux.

• #38 Gastroesophageal Reflux Disease (GERD) – Harvard Health

  https://www.health.harvard.edu/a_to_z/gastroesophageal-reflux-disease-gerd-a-to-z

  Eat smaller, more frequent meals. […] Do not lie down after eating. […] Do not eat during the three to four hours before you go to bed. […] If you smoke, quit. […] Avoid drinking alcohol. It loosens the esophageal sphincter. […] Lose weight if you are obese. Obesity can make it harder for the esophageal sphincter to stay closed. […] Avoid wearing tight-fitting garments. Increased pressure on the abdomen can open the esophageal sphincter. […] Use lozenges or gum to keep producing saliva.

• #39 Acid Reflux & GERD: Symptoms, What It Is, Causes, Treatment

  https://my.clevelandclinic.org/health/diseases/17019-acid-reflux-gerd

  Some people find they can reduce acid reflux with lifestyle adjustments, like changing their eating habits, reducing alcohol and tobacco and losing weight. Healthcare providers encourage this approach. […] If you have severe GERD or it causes complications that medicine can’t help, you might need surgery. But surgery is usually minor and effective. It’s worth treating GERD to prevent its complications. […] To help manage acid reflux at home, try: Eating smaller meals. Larger meals expand your stomach and put pressure on your LES. Smaller meals digest faster and don’t stimulate your stomach to produce so much acid. […] Quitting smoking and drinking. Both tobacco and alcohol weaken your LES. They also affect your stomach, making it more acidic and slowing your digestion time. […] If you have acid reflux frequently, talk to a healthcare provider. It’s important to find out how it’s affecting your body. GERD isn’t just an inconvenience – it can do real harm. It’s also very treatable.

• #40 How to Prevent Acid Reflux and Heartburn

  https://www.healthline.com/health/gerd/preventing-heartburn

  Mild cases of acid reflux can often be prevented by adopting a few lifestyle changes, such as avoiding certain foods or not lying down immediately after a meal. […] If you regularly experience acid reflux, certain lifestyle and dietary changes may help. […] Occasional or mild cases of acid reflux can usually be prevented by adopting a few lifestyle changes. […] Sleeping on your left side may help to reduce acid reflux symptoms at night. […] A 2021 systematic review examined existing research suggesting that elevating your head while sleeping may help reduce acid reflux symptoms. […] If you have excess belly fat, the pressure in your abdomen may cause your lower esophageal sphincter to be pushed upward, away from the support of your diaphragm. […] Smoking also lowers the pressure in the lower esophageal sphincter, which can cause coughing and acid reflux. Research shows that quitting smoking can reduce the severity of your acid reflux or GERD.

• #41 Gastroesophageal Reflux Disease (GERD) – Whole Health Library

  https://www.va.gov/WHOLEHEALTHLIBRARY/tools/gastroesophageal-reflux-disease-gerd.asp

  Gastroesophageal reflux disease (GERD) is an extremely common condition, affecting nearly 1 in 5 U.S. adults at least weekly and nearly 1 in 10 daily. […] Primary prevention of GERD should be based on health screening and prevention recommendations that apply to all Veterans. Perhaps the most important of these include maintaining a healthy weight, avoiding tobacco products, and limiting excess alcohol consumption. […] Although there is inconsistent evidence on which foods may provoke symptoms (food eliminations must be individualized), it is clear that avoiding large meals and eating within 2-3 hours of bedtime can improve symptoms. […] In those with a previous personal history or family history of GERD, it may also be prudent to avoid potentially provocative medications, when possible.

• #42 How to Prevent Gastroesophageal Reflux Disease (GERD)

  https://www.everydayhealth.com/digestive-health/how-to-prevent-gerd/

  When it comes to preventing GERD, it’s not just what you eat that matters; it’s also when and how much you eat. Large meal volumes cause greater gastric distension and may take longer to empty from the stomach. This can lead to more frequent air venting through a process called transient lower esophageal sphincter relaxation (TLESR). Eating right before you go to sleep can also be problematic, especially if it’s a large meal. This is why we recommend patients with GERD to eat smaller, potentially more frequent meals, and avoid eating close to bedtime. […] Smoking exacerbates GERD by weakening the sphincter, a ring-shaped muscle that separates the esophagus from the stomach. This can allow stomach contents to flow back up into the esophagus. Quitting smoking is one of the best things people can do not only for GERD, but their overall health. Tight clothes, especially around the waistband, can increase abdominal pressure, which can cause stomach acid to flow back up into the esophagus. In people prone to reflux symptoms, it is therefore recommended that they avoid form-fitting clothes or use of a tight belt.

• #43 Lifestyle Changes for Gastroesophageal Reflux Disease | NYU Langone Health

  https://nyulangone.org/conditions/gastroesophageal-reflux-disease/treatments/lifestyle-changes-for-gastroesophageal-reflux-disease

  Eat smaller and more frequent meals each day instead of a few large meals. This promotes digestion and can aid in preventing heartburn. […] Wear loose-fitting clothes to ease pressure on the stomach, which can worsen heartburn and reflux. […] Quit smoking. Smoking can increase the production of stomach acid and reduce the function of the lower esophageal sphincter, the muscle that keeps acid and other stomach content from reentering the esophagus. Smoking can also decrease the amount of saliva, which neutralizes acid produced by the body. […] Reduce excess weight around the midsection. This can ease pressure on the stomach. Such pressure can force some stomach contents back up the esophagus.

• #44 Gastroesophageal reflux disease (GERD) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gerd/diagnosis-treatment/drc-20361959

  Don’t lie down after a meal. Wait at least three hours after eating before lying down or going to bed. […] Eat food slowly and chew thoroughly. Put down your fork after every bite and pick it up again once you have chewed and swallowed that bite. […] Don’t consume foods and drinks that trigger reflux. Common triggers include alcohol, chocolate, caffeine, fatty foods or peppermint. […] Don’t wear tight-fitting clothing. Clothes that fit tightly around the waist put pressure on the abdomen and the lower esophageal sphincter.

• #45 Patient education: Gastroesophageal reflux disease in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/gastroesophageal-reflux-disease-in-adults-beyond-the-basics

  While evidence is limited, other changes also sometimes seem to help, such as: […] Avoiding late meals – Lying down with a full stomach may increase the risk of acid reflux. By planning meals for at least two to three hours before bedtime, symptoms may be reduced. This is especially true for people with nighttime reflux. […] Wearing loose, comfortable clothing – At minimum, tight-fitting clothing can increase discomfort, but it may also increase pressure in the abdomen, promoting hiatus hernia and forcing stomach contents into the esophagus. […] Mild symptoms – In addition to lifestyle changes, the initial treatment of mild GERD includes the use of nonprescription antacids or histamine receptor antagonists. […] Moderate to severe symptoms – People with more severe or frequent symptoms, complications related to GERD, or mild symptoms that have not responded to the above medications usually require treatment with a medication called a proton pump inhibitor (PPI). Lifestyle changes can help as well.

• #46 How to Prevent Gastroesophageal Reflux Disease (GERD)

  https://www.everydayhealth.com/digestive-health/how-to-prevent-gerd/

  When it comes to preventing GERD, it’s not just what you eat that matters; it’s also when and how much you eat. Large meal volumes cause greater gastric distension and may take longer to empty from the stomach. This can lead to more frequent air venting through a process called transient lower esophageal sphincter relaxation (TLESR). Eating right before you go to sleep can also be problematic, especially if it’s a large meal. This is why we recommend patients with GERD to eat smaller, potentially more frequent meals, and avoid eating close to bedtime. […] Smoking exacerbates GERD by weakening the sphincter, a ring-shaped muscle that separates the esophagus from the stomach. This can allow stomach contents to flow back up into the esophagus. Quitting smoking is one of the best things people can do not only for GERD, but their overall health. Tight clothes, especially around the waistband, can increase abdominal pressure, which can cause stomach acid to flow back up into the esophagus. In people prone to reflux symptoms, it is therefore recommended that they avoid form-fitting clothes or use of a tight belt.

• #47 Five lifestyle factors that can help prevent gastroesophageal reflux disease – Harvard Health

  https://www.health.harvard.edu/blog/five-lifestyle-factors-that-can-help-prevent-gastroesophageal-reflux-disease-202105122454

  Gastroesophageal reflux disease (GERD) is a common condition in which the reflux of stomach contents into the esophagus causes troublesome symptoms or complications. […] Despite the overall safety and effectiveness of antireflux medications, concerns over their use have led to increased interest in lifestyle factors that can be helpful in managing GERD. Many common-sense lifestyle interventions are frequently recommended for preventing and treating GERD, but for many of these interventions, specific data supporting their effectiveness is lacking. […] The study authors identified five lifestyle factors that predicted which study participants were less likely to develop GERD. These five factors were: normal body weight (body mass index between 18.5 and 25), never smoking, moderate to vigorous physical activity for at least 30 minutes daily, no more than two cups of coffee/tea/soda daily, and a healthy diet (comparatively higher intake of fruits, vegetables, whole grains, legumes, poultry, and fish). […] This study adds to an increasing body of evidence suggesting that lifestyle interventions may play a significant role in preventing GERD. […] Lifestyle interventions and antireflux medications will thus continue to play important complementary roles in GERD management moving forward.

• #48 Gastroesophageal Reflux Disease (GERD) – Whole Health Library

  https://www.va.gov/WHOLEHEALTHLIBRARY/tools/gastroesophageal-reflux-disease-gerd.asp

  Based on the Strength of Recommendation Taxonomy (SORT) criteria, there are no known nonpharmaceutical therapies for GERD with consistent, good-quality, and patient-oriented evidence. […] The following therapies are based on inconsistent or limited-quality, patient-oriented evidence and would receive a B rating: Nearly daily moderate to vigorous exercise for 30-60 minutes, away from mealtime; Food elimination diet; Increase fiber to meet general recommendations; Elevate head of bed (consider only in those with severe symptoms); Avoid large meals and eating 2-3 hours before bedtime; Acupuncture; Melatonin; Diaphragmatic Breathing.

• #49 Gastroesophageal Reflux Disease (GERD) – Whole Health Library

  https://www.va.gov/WHOLEHEALTHLIBRARY/tools/gastroesophageal-reflux-disease-gerd.asp

  Based on the Strength of Recommendation Taxonomy (SORT) criteria, there are no known nonpharmaceutical therapies for GERD with consistent, good-quality, and patient-oriented evidence. […] The following therapies are based on inconsistent or limited-quality, patient-oriented evidence and would receive a B rating: Nearly daily moderate to vigorous exercise for 30-60 minutes, away from mealtime; Food elimination diet; Increase fiber to meet general recommendations; Elevate head of bed (consider only in those with severe symptoms); Avoid large meals and eating 2-3 hours before bedtime; Acupuncture; Melatonin; Diaphragmatic Breathing.

• #50 Gastroesophageal Reflux Disease (GERD) – Symptoms & Treatment | MedStar Health

  https://www.medstarhealth.org/services/gastroesophageal-reflux-disease-gerd

  Gastroesophageal reflux disease, commonly known as GERD, is a severe, chronic form of acid reflux. […] If acid reflux and heartburn are interfering with your life, its time to see a doctor specializing in GERD. […] From antacid medications and conservative therapies to minimally invasive surgery, were here to help you prevent minor heartburn from becoming a major health issue. […] Early detection and intervention can help to minimize your risk of long-term complications. […] Several lifestyle and habit modifications may improve acid reflux symptoms. Your doctor may recommend: Achieving and maintaining a healthy weight, Eating smaller meals, Avoiding eating within two hours of lying down to sleep, Quitting smoking, Minimizing caffeine, Getting active after eating to promote digestion, Avoiding citrusy, fatty, or spicy foods.

• #51 Non-Surgical Treatment Options for GERD | Brown University Health

  https://www.brownhealth.org/centers-services/general-and-gastrointestinal-surgery/gastroesophageal-reflux-disease/non-surgical

  Reducing intra-abdominal pressure, i.e., avoiding tight clothing, not eating immediately before going to bed and avoiding heavy lifting. […] Increasing lower esophageal (LES) pressure by avoiding coffee, tea and cola which, because of their caffeine content, decrease LES pressure. Alcohol, cigarettes and nicotine also decrease LES pressure. […] Using medications that may increase the LES pressure directly, such as Propulsid (cisapride) and Reglan (metoclopramide). […] Improving gastric emptying by avoiding fatty foods and alcohol, which delay the emptying of the stomach. […] Using medications that decrease acid production, e.g., the H2 blockers Axid (nizatidine), Tagamet (cimetidine), Pepcid (famotidine), and Zantac (ranitidine), as well as the proton pump inhibitors Prilosec (omeprazole) and Prevacid (lansoprazole).

• #52 Gastroesophageal reflux disease – Wikipedia

  https://en.wikipedia.org/wiki/Gastroesophageal_reflux_disease

  Weight loss is recommended for the overweight or obese, as well as avoidance of bedtime snacks or lying down immediately after meals (meals should occur at least 23 hours before bedtime), elevation of the head of the bed on 6-inch blocks, avoidance of smoking, and avoidance of tight clothing that increases pressure in the stomach. […] Although moderate exercise may improve symptoms in people with GERD, vigorous exercise may worsen them. Breathing exercises may relieve GERD symptoms. […] The standard surgical treatment for severe GERD is the Nissen fundoplication. In this procedure, the upper part of the stomach is wrapped around the lower esophageal sphincter to strengthen the sphincter and prevent acid reflux and to repair a hiatal hernia. […] It is recommended only for those who do not improve with PPIs.

• #53 Gastroesophageal reflux disease – Wikipedia

  https://en.wikipedia.org/wiki/Gastroesophageal_reflux_disease

  Weight loss is recommended for the overweight or obese, as well as avoidance of bedtime snacks or lying down immediately after meals (meals should occur at least 23 hours before bedtime), elevation of the head of the bed on 6-inch blocks, avoidance of smoking, and avoidance of tight clothing that increases pressure in the stomach. […] Although moderate exercise may improve symptoms in people with GERD, vigorous exercise may worsen them. Breathing exercises may relieve GERD symptoms. […] The standard surgical treatment for severe GERD is the Nissen fundoplication. In this procedure, the upper part of the stomach is wrapped around the lower esophageal sphincter to strengthen the sphincter and prevent acid reflux and to repair a hiatal hernia. […] It is recommended only for those who do not improve with PPIs.

• #54 Non-Surgical Treatment Options for GERD | Brown University Health

  https://www.brownhealth.org/centers-services/general-and-gastrointestinal-surgery/gastroesophageal-reflux-disease/non-surgical

  Avoiding foods that increase acid production or are very acidic. For example, caffeine, alcohol, peppermint and nicotine all stimulate the production of acid. Citrus fruits, onions and tomatoes all contain a lot of acid. Spicy foods should be avoided because they burn even if there is not a lot of acid in them. […] Avoiding situations that increase acid production by the stomach, like stress.

• #55 How Can I Prevent Heartburn and Other Symptoms of GERD?

  https://www.webmd.com/heartburn-gerd/understanding-gerd-prevention

  Get on a GERD Diet […] A key way to prevent it is to make tweaks to your diet and the way you eat. […] Have small, frequent meals. […] Avoid trigger foods. […] Cut back on alcohol, tea, coffee, and carbonated drinks. […] Tweak Your Bedtime Routine […] Don’t eat before bedtime. […] Prop up the head of your bed 6 to 10 inches. […] Stop Smoking […] You can also prevent heartburn if you ditch cigarettes, since smoking can trigger GERD symptoms. […] Lose Weight if You Need To […] Obesity has been linked to GERD. […] Avoid Certain Medications […] Some over-the-counter pain drugs can make GERD worse, including aspirin, ibuprofen, and naproxen. […] Other Tips to Prevent GERD […] Relieve stress: See if yoga, meditation, or tai chi can cut your symptoms. […] Chew gum after meals: You’ll make more saliva, which helps neutralize heartburn-causing acid. […] Wear loose clothing: Tight clothing, especially around your stomach, can push stomach acid upward.

• #56 Gastroesophageal Reflux Disease (GERD) | TGH Urgent Care

  https://www.fasttrackurgentcare.com/gastroesophageal-reflux-disease-gerd/

  Preventing GERD involves adopting healthy lifestyle habits and making dietary and behavioral changes. Here are some strategies to reduce the risk of GERD: […] Maintaining a healthy body weight can reduce abdominal pressure and decrease the risk of developing GERD. […] Quitting smoking can improve LES function and reduce the risk of GERD. […] Sleeping with the upper body elevated can help prevent nighttime acid reflux. […] Practicing relaxation techniques and stress management can reduce the impact of stress on GERD symptoms. […] In some cases, medications such as antacids or H2 blockers may be used on a preventive basis, particularly before consuming known trigger foods.

• #57 Gastroesophageal Reflux Disease (GERD) – Whole Health Library

  https://www.va.gov/WHOLEHEALTHLIBRARY/tools/gastroesophageal-reflux-disease-gerd.asp

  Based on the Strength of Recommendation Taxonomy (SORT) criteria, there are no known nonpharmaceutical therapies for GERD with consistent, good-quality, and patient-oriented evidence. […] The following therapies are based on inconsistent or limited-quality, patient-oriented evidence and would receive a B rating: Nearly daily moderate to vigorous exercise for 30-60 minutes, away from mealtime; Food elimination diet; Increase fiber to meet general recommendations; Elevate head of bed (consider only in those with severe symptoms); Avoid large meals and eating 2-3 hours before bedtime; Acupuncture; Melatonin; Diaphragmatic Breathing.

• #58 GERD: A practical approach | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/4/223

  If lifestyle interventions fail, drug treatment options are PPIs, histamine 2 receptor antagonists (H2RAs), and antacids. […] PPIs are considered the therapy of choice for symptomatic relief and healing of erosive esophagitis. […] After the initial 8-week course of therapy, most patients with GERD should attempt to take the lowest dose required to manage their symptoms. […] If first-line therapy fails, PPIs have immensely changed the landscape of treatment for GERD since their introduction, but up to 40% of patients with GERD find partial or no symptom relief with first-line therapies. […] Alternative therapies are being investigated, but none have consistently shown significant benefits over placebo. […] Indications for the procedure are presence of a large hiatal hernia, reflux esophagitis or GERD symptoms refractory to medical therapy, or adverse effects of medical therapy. […] The Linx procedure (magnetic sphincter augmentation; Torax Medical Inc., Shoreview, MN) is a minimally invasive alternative. It involves laparoscopic insertion of a band of magnetic beads around the LES, which allows passage of food and then closes to prevent acid reflux.

• #59 Gastroesophageal reflux disease (GERD) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940

  Most people can manage the discomfort of GERD with lifestyle changes and medicines. […] GERD is caused by frequent acid reflux or reflux of nonacidic content from the stomach. […] Factors that can aggravate acid reflux include: Smoking. […] Eating large meals or eating late at night. […] Eating certain foods, such as fatty or fried foods. […] Drinking certain beverages, such as alcohol or coffee. […] Taking certain medicines, such as aspirin.

• #60 Gastroesophageal Reflux Disease (GERD) – Whole Health Library

  https://www.va.gov/WHOLEHEALTHLIBRARY/tools/gastroesophageal-reflux-disease-gerd.asp

  Gastroesophageal reflux disease (GERD) is an extremely common condition, affecting nearly 1 in 5 U.S. adults at least weekly and nearly 1 in 10 daily. […] Primary prevention of GERD should be based on health screening and prevention recommendations that apply to all Veterans. Perhaps the most important of these include maintaining a healthy weight, avoiding tobacco products, and limiting excess alcohol consumption. […] Although there is inconsistent evidence on which foods may provoke symptoms (food eliminations must be individualized), it is clear that avoiding large meals and eating within 2-3 hours of bedtime can improve symptoms. […] In those with a previous personal history or family history of GERD, it may also be prudent to avoid potentially provocative medications, when possible.

• #61 How Can I Prevent Heartburn and Other Symptoms of GERD?

  https://www.webmd.com/heartburn-gerd/understanding-gerd-prevention

  Get on a GERD Diet […] A key way to prevent it is to make tweaks to your diet and the way you eat. […] Have small, frequent meals. […] Avoid trigger foods. […] Cut back on alcohol, tea, coffee, and carbonated drinks. […] Tweak Your Bedtime Routine […] Don’t eat before bedtime. […] Prop up the head of your bed 6 to 10 inches. […] Stop Smoking […] You can also prevent heartburn if you ditch cigarettes, since smoking can trigger GERD symptoms. […] Lose Weight if You Need To […] Obesity has been linked to GERD. […] Avoid Certain Medications […] Some over-the-counter pain drugs can make GERD worse, including aspirin, ibuprofen, and naproxen. […] Other Tips to Prevent GERD […] Relieve stress: See if yoga, meditation, or tai chi can cut your symptoms. […] Chew gum after meals: You’ll make more saliva, which helps neutralize heartburn-causing acid. […] Wear loose clothing: Tight clothing, especially around your stomach, can push stomach acid upward.

• #62 Gastroesophageal reflux disease – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/gastroesophageal-reflux-disease/

  Reduce or avoid triggering substances: Tobacco, alcohol, and/or caffeine if the patient experiences correlation with symptoms, Medications that may worsen symptoms (e.g., CCBs, diazepam). […] Antireflux surgery may be considered for select patients after careful evaluation. Predictors of successful outcomes include: Symptoms that correlate objectively with reflux episodes using ambulatory esophageal pH monitoring, Prior good response to PPIs. […] Indications: Discontinuation of medical therapy (e.g., due to nonadherence or side effects), Symptoms refractory to medical therapy, Complications despite optimal medical therapy, e.g., severe esophagitis, strictures, recurrent aspiration, Large hiatal hernia.

• #63 Gastroesophageal reflux disease – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/gastroesophageal-reflux-disease/

  Reduce or avoid triggering substances: Tobacco, alcohol, and/or caffeine if the patient experiences correlation with symptoms, Medications that may worsen symptoms (e.g., CCBs, diazepam). […] Antireflux surgery may be considered for select patients after careful evaluation. Predictors of successful outcomes include: Symptoms that correlate objectively with reflux episodes using ambulatory esophageal pH monitoring, Prior good response to PPIs. […] Indications: Discontinuation of medical therapy (e.g., due to nonadherence or side effects), Symptoms refractory to medical therapy, Complications despite optimal medical therapy, e.g., severe esophagitis, strictures, recurrent aspiration, Large hiatal hernia.

• #64 Gastroesophageal Reflux Disease

  https://www.aaaai.org/conditions-treatments/related-conditions/gastroesophageal-reflux-disease

  Gastroesophageal reflux disease (GERD) is a digestive disorder that occurs when acidic stomach juices, or food and fluids back up from the stomach into the esophagus. […] If you have both GERD and asthma, managing your GERD will help control your asthma symptoms. […] Studies have shown that people with asthma and GERD saw a decrease in asthma symptoms (and asthma medication use) after treating their reflux disease. […] Lifestyle changes to treat GERD include: Elevate the head of the bed 6-8 inches Lose weight Stop smoking Decrease alcohol intake Limit meal size and avoid heavy evening meals Do not lie down within two to three hours of eating Decrease caffeine intake Avoid theophylline (if possible). […] Your physician may also recommend medications to treat reflux or relieve symptoms. Over-the-counter antacids and H2 blockers may help decrease the effects of stomach acid. Proton pump inhibitors block acid production and also may be effective. […] In severe and medication intolerant cases, surgery may be recommended.

• #65 Gastroesophageal Reflux Disease (GERD) – Whole Health Library

  https://www.va.gov/WHOLEHEALTHLIBRARY/tools/gastroesophageal-reflux-disease-gerd.asp

  Gastroesophageal reflux disease (GERD) is an extremely common condition, affecting nearly 1 in 5 U.S. adults at least weekly and nearly 1 in 10 daily. […] Primary prevention of GERD should be based on health screening and prevention recommendations that apply to all Veterans. Perhaps the most important of these include maintaining a healthy weight, avoiding tobacco products, and limiting excess alcohol consumption. […] Although there is inconsistent evidence on which foods may provoke symptoms (food eliminations must be individualized), it is clear that avoiding large meals and eating within 2-3 hours of bedtime can improve symptoms. […] In those with a previous personal history or family history of GERD, it may also be prudent to avoid potentially provocative medications, when possible.

• #66 Gastroesophageal Reflux Disease (GERD) Health Library

  https://paleymd.com/patient-education/healthwise?DOCHWID=hw99177

  You may be able to prevent GERD with lifestyle changes, such as eating healthy foods, not smoking, and staying at a weight that is healthy for you. Talk to your doctor if you need help losing weight. […] Some medicines may cause GERD as a side effect. If any medicines you take seem to be the cause of your heartburn, talk with your doctor. Don’t stop taking a prescription medicine until you talk with your doctor.

• #67 Treatment for GER & GERD – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/treatment

  Your doctor may recommend that you make lifestyle changes and take medicines to manage symptoms of gastroesophageal reflux (GER) or gastroesophageal reflux disease (GERD). […] Lifestyle changes may reduce your symptoms. Your doctor may recommend losing weight if you’re overweight or have obesity, elevating your head during sleep by placing a foam wedge or extra pillows under your head and upper back to incline your body and raise your head off your bed 6 to 8 inches, quitting smoking, if you smoke, changing your eating habits and diet. […] Your doctor may prescribe one or more medicines to treat GERD. […] Your doctor may recommend surgery if your GERD symptoms don’t improve with lifestyle changes and medicines, or if you wish to stop taking long-term GERD medicines to manage symptoms. […] If you have GERD and obesity, your doctor may recommend weight-loss surgery, most often gastric bypass surgery. Weight-loss surgery can help you lose weight and reduce GERD symptoms.

• #68 Management of Gastroesophageal Reflux Disease | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/1001/p1311.html

  The primary treatment goals in patients with gastroesophageal reflux disease are relief of symptoms, prevention of symptom relapse, healing of erosive esophagitis, and prevention of complications of esophagitis. […] Based on expert opinion, lifestyle modifications should be initiated and continued throughout the course of therapy in patients with a history that is typical of uncomplicated GERD. […] Although there is little supporting evidence, it is considered reasonable to educate patients about various factors that may precipitate reflux. […] Over-the-counter acid suppressants and antacids are considered appropriate initial therapy for GERD. […] A number of RCTs have shown that H2RAs, given in standard dosages, are more effective than placebo for relieving heartburn in patients with GERD; within a few weeks of initiating treatment, up to 70 percent of patients reported symptomatic relief.

• #69 Management of Gastroesophageal Reflux Disease | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/1001/p1311.html

  The primary treatment goals in patients with gastroesophageal reflux disease are relief of symptoms, prevention of symptom relapse, healing of erosive esophagitis, and prevention of complications of esophagitis. […] Based on expert opinion, lifestyle modifications should be initiated and continued throughout the course of therapy in patients with a history that is typical of uncomplicated GERD. […] Although there is little supporting evidence, it is considered reasonable to educate patients about various factors that may precipitate reflux. […] Over-the-counter acid suppressants and antacids are considered appropriate initial therapy for GERD. […] A number of RCTs have shown that H2RAs, given in standard dosages, are more effective than placebo for relieving heartburn in patients with GERD; within a few weeks of initiating treatment, up to 70 percent of patients reported symptomatic relief.

• #70 Managing GERD: How to prevent acid reflux and GERD symptoms – UChicago Medicine

  https://www.uchicagomedicine.org/forefront/gastrointestinal-articles/2023/december/managing-gerd-how-to-prevent-acid-reflux-and-gerd-symptoms

  Minimize carbonated beverages and alcohol. Drink more water. Carbonated beverages and alcohol can cause relaxation of the LES muscle and trigger GERD. If you drink more water, it will clear the esophagus and reduce acid reflux. […] Avoid the triggers that give you GERD symptoms. While everyone may have different triggers, a few of the common foods and drinks that can lead to a GERD episode are: Garlic, Raw onions, Chocolate, Red wine, Peppermint, Citrus fruits. […] Keep your preferred antacid on standby. Prepare for a potential GERD episode by keeping your over-the-counter antacids or medicine prescribed by your doctor handy.

• #71 Management of Gastroesophageal Reflux Disease | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/1001/p1311.html

  The primary treatment goals in patients with gastroesophageal reflux disease are relief of symptoms, prevention of symptom relapse, healing of erosive esophagitis, and prevention of complications of esophagitis. […] Based on expert opinion, lifestyle modifications should be initiated and continued throughout the course of therapy in patients with a history that is typical of uncomplicated GERD. […] Although there is little supporting evidence, it is considered reasonable to educate patients about various factors that may precipitate reflux. […] Over-the-counter acid suppressants and antacids are considered appropriate initial therapy for GERD. […] A number of RCTs have shown that H2RAs, given in standard dosages, are more effective than placebo for relieving heartburn in patients with GERD; within a few weeks of initiating treatment, up to 70 percent of patients reported symptomatic relief.

• #72 How Can I Prevent Heartburn and Other Symptoms of GERD?

  https://www.webmd.com/heartburn-gerd/understanding-gerd-prevention

  Get on a GERD Diet […] A key way to prevent it is to make tweaks to your diet and the way you eat. […] Have small, frequent meals. […] Avoid trigger foods. […] Cut back on alcohol, tea, coffee, and carbonated drinks. […] Tweak Your Bedtime Routine […] Don’t eat before bedtime. […] Prop up the head of your bed 6 to 10 inches. […] Stop Smoking […] You can also prevent heartburn if you ditch cigarettes, since smoking can trigger GERD symptoms. […] Lose Weight if You Need To […] Obesity has been linked to GERD. […] Avoid Certain Medications […] Some over-the-counter pain drugs can make GERD worse, including aspirin, ibuprofen, and naproxen. […] Other Tips to Prevent GERD […] Relieve stress: See if yoga, meditation, or tai chi can cut your symptoms. […] Chew gum after meals: You’ll make more saliva, which helps neutralize heartburn-causing acid. […] Wear loose clothing: Tight clothing, especially around your stomach, can push stomach acid upward.

• #73

  https://journals.lww.com/ajg/fulltext/2022/01000/acg_clinical_guideline_for_the_diagnosis_and.14.aspx

  For patients with GERD who require maintenance therapy with PPIs, the PPIs should be administered in the lowest dose that effectively controls GERD symptoms and maintains healing of reflux esophagitis (conditional recommendation, low level of evidence). […] We recommend against routine addition of medical therapies in PPI nonresponders (conditional recommendation, moderate level of evidence). […] We recommend maintenance PPI therapy indefinitely or antireflux surgery for patients with LA grade C or D esophagitis (strong recommendation, moderate level of evidence). […] We do not recommend baclofen in the absence of objective evidence of GERD (strong recommendation, moderate level of evidence). […] We recommend against treatment with a prokinetic agent of any kind for GERD therapy unless there is objective evidence of gastroparesis (strong recommendation, low level of evidence). […] We do not recommend sucralfate for GERD therapy except during pregnancy (strong recommendation, low level of evidence). […] We suggest on-demand or intermittent PPI therapy for heartburn symptom control in patients with NERD (conditional recommendation, low level of evidence).

• #74

  https://journals.lww.com/ajg/fulltext/2022/01000/acg_clinical_guideline_for_the_diagnosis_and.14.aspx

  For patients with GERD who require maintenance therapy with PPIs, the PPIs should be administered in the lowest dose that effectively controls GERD symptoms and maintains healing of reflux esophagitis (conditional recommendation, low level of evidence). […] We recommend against routine addition of medical therapies in PPI nonresponders (conditional recommendation, moderate level of evidence). […] We recommend maintenance PPI therapy indefinitely or antireflux surgery for patients with LA grade C or D esophagitis (strong recommendation, moderate level of evidence). […] We do not recommend baclofen in the absence of objective evidence of GERD (strong recommendation, moderate level of evidence). […] We recommend against treatment with a prokinetic agent of any kind for GERD therapy unless there is objective evidence of gastroparesis (strong recommendation, low level of evidence). […] We do not recommend sucralfate for GERD therapy except during pregnancy (strong recommendation, low level of evidence). […] We suggest on-demand or intermittent PPI therapy for heartburn symptom control in patients with NERD (conditional recommendation, low level of evidence).

• #75 GERD: A practical approach | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/4/223

  If lifestyle interventions fail, drug treatment options are PPIs, histamine 2 receptor antagonists (H2RAs), and antacids. […] PPIs are considered the therapy of choice for symptomatic relief and healing of erosive esophagitis. […] After the initial 8-week course of therapy, most patients with GERD should attempt to take the lowest dose required to manage their symptoms. […] If first-line therapy fails, PPIs have immensely changed the landscape of treatment for GERD since their introduction, but up to 40% of patients with GERD find partial or no symptom relief with first-line therapies. […] Alternative therapies are being investigated, but none have consistently shown significant benefits over placebo. […] Indications for the procedure are presence of a large hiatal hernia, reflux esophagitis or GERD symptoms refractory to medical therapy, or adverse effects of medical therapy. […] The Linx procedure (magnetic sphincter augmentation; Torax Medical Inc., Shoreview, MN) is a minimally invasive alternative. It involves laparoscopic insertion of a band of magnetic beads around the LES, which allows passage of food and then closes to prevent acid reflux.

• #76

  https://journals.lww.com/ajg/fulltext/2022/01000/acg_clinical_guideline_for_the_diagnosis_and.14.aspx

  We suggest elevating head of bed for nighttime GERD symptoms (conditional recommendation, low level of evidence). […] We recommend treatment with PPIs over treatment with histamine-2-receptor antagonists (H2RA) for healing EE (strong recommendation, high level of evidence). […] We recommend treatment with PPIs over H2RA for maintenance of healing from EE (strong recommendation, moderate level of evidence). […] We recommend PPI administration 30-60 minutes before a meal rather than at bedtime for GERD symptom control (strong recommendation, moderate level of evidence). […] For patients with GERD who do not have EE or Barrett’s esophagus, and whose symptoms have resolved with PPI therapy, an attempt should be made to discontinue PPIs or to switch to on-demand therapy in which PPIs are taken only when symptoms occur and discontinued when they are relieved (conditional recommendation, low level of evidence).

• #77 Management of Gastroesophageal Reflux Disease | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/1001/p1311.html

  If a patient who was initially started on twice-daily H2RA therapy does not respond after two weeks, appropriate step-up therapy is to switch to once-daily PPI therapy. […] Evidence also indicates that step-up therapy and step-down therapy are cost-effective and should be used. […] Consideration of antireflux surgery must be individualized. Indications for surgery include failed medical management, patient preference for surgery despite successful medical management, complications of GERD, medical complications attributable to a large hiatal hernia, or atypical symptoms with reflux documented on 24-hour pH monitoring. […] The goals of radiofrequency heating of the gastroesophageal junction (Stretta procedure) and endoscopic gastroplasty (endocinch procedure) are to reduce medication use, improve quality of life, and decrease reflux symptoms in patients who have GERD, without the costs and risks associated with conventional antireflux surgery.

• #78 Management of gastroesophageal reflux disease (GERD) – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/management-of-gastroesophageal-reflux-disease-gerd/

  1. AGA recommends weight loss should be advised for overweight or obese patients with esophageal GERD syndromes. […] 2. AGA recommends elevation of the head of the bed for selected patients who are troubled with heartburn or regurgitation when recumbent. Other lifestyle modifications including, but not limited to, avoiding late meals, avoiding specific foods or avoiding specific activities should be tailored to the circumstances of the individual patient. […] 3. AGA strongly recommends antisecretory drugs for the treatment of patients with esophageal GERD syndromes (healing esophagitis and symptomatic relief). In these uses, proton pump inhibitors (PPIs) are more effective than histamine2 receptor antagonists (H2RAs), which are more effective than placebo. […] 4. AGA recommends twice-daily PPI therapy for patients with an esophageal syndrome with an inadequate symptom response to once-daily PPI therapy.

• #79

  https://journals.lww.com/ajg/fulltext/2022/01000/acg_clinical_guideline_for_the_diagnosis_and.14.aspx

  We suggest elevating head of bed for nighttime GERD symptoms (conditional recommendation, low level of evidence). […] We recommend treatment with PPIs over treatment with histamine-2-receptor antagonists (H2RA) for healing EE (strong recommendation, high level of evidence). […] We recommend treatment with PPIs over H2RA for maintenance of healing from EE (strong recommendation, moderate level of evidence). […] We recommend PPI administration 30-60 minutes before a meal rather than at bedtime for GERD symptom control (strong recommendation, moderate level of evidence). […] For patients with GERD who do not have EE or Barrett’s esophagus, and whose symptoms have resolved with PPI therapy, an attempt should be made to discontinue PPIs or to switch to on-demand therapy in which PPIs are taken only when symptoms occur and discontinued when they are relieved (conditional recommendation, low level of evidence).

• #80

  https://journals.lww.com/ajg/fulltext/2022/01000/acg_clinical_guideline_for_the_diagnosis_and.14.aspx

  For patients with GERD who require maintenance therapy with PPIs, the PPIs should be administered in the lowest dose that effectively controls GERD symptoms and maintains healing of reflux esophagitis (conditional recommendation, low level of evidence). […] We recommend against routine addition of medical therapies in PPI nonresponders (conditional recommendation, moderate level of evidence). […] We recommend maintenance PPI therapy indefinitely or antireflux surgery for patients with LA grade C or D esophagitis (strong recommendation, moderate level of evidence). […] We do not recommend baclofen in the absence of objective evidence of GERD (strong recommendation, moderate level of evidence). […] We recommend against treatment with a prokinetic agent of any kind for GERD therapy unless there is objective evidence of gastroparesis (strong recommendation, low level of evidence). […] We do not recommend sucralfate for GERD therapy except during pregnancy (strong recommendation, low level of evidence). […] We suggest on-demand or intermittent PPI therapy for heartburn symptom control in patients with NERD (conditional recommendation, low level of evidence).

• #81 Gastroesophageal Reflux Disease (GERD)/Heartburn | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/g/gastroesophageal-reflux-disease-gerdheartburn.html

  Some of the same diet and lifestyle changes that are used to treat GERD can also help to prevent it. […] In many cases, making diet and lifestyle changes reduces GERD symptoms. Always check with your healthcare provider before making any changes. […] If you have GERD, be careful about what you eat and drink. Dont have too much of these: Fried and fatty foods, Peppermint, Chocolate, Alcohol, Citrus fruit and juices, Tomato products, Drinks with caffeine, such as coffee, soda, and energy drinks. […] You should also: Eat smaller amounts, Not overeat, Quit smoking, Not drink too much alcohol, Wait a few hours after eating before you lie down or go to bed, Lose weight if needed, Raise the head of your bed 6 inches. […] Check any medicines you are taking. Some may cause problems with the lining of your stomach or esophagus. You may also want to talk with your healthcare provider about: Taking medicines to reduce your stomach acid (antacids), Taking medicines called H2-blockers and proton pump inhibitors to reduce stomach acid. […] Some of the same diet and lifestyle changes that are used to treat GERD can also help to prevent it.

• #82 Management of gastroesophageal reflux disease (GERD) – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/management-of-gastroesophageal-reflux-disease-gerd/

  20. AGA strongly recommends that when a patient with an esophageal GERD syndrome is responsive to, but intolerant of, acid suppressive therapy, antireflux surgery should be recommended as an alternative. […] 21. AGA recommends antireflux surgery for patients with an esophageal GERD syndrome with persistent troublesome symptoms, especially troublesome regurgitation, despite PPI therapy. The potential benefits of antireflux surgery should be weighed against the deleterious effect of new symptoms consequent from surgery, particularly dysphagia, flatulence, an inability to belch, and postsurgery bowel symptoms. […] 22. AGA recommends against antireflux surgery for patients with an esophageal syndrome with or without tissue damage who are symptomatically well controlled on medical therapy. […] 23. AGA recommends against antireflux surgery as an antineoplastic measure in patients with Barrett’s metaplasia.

• #83 Gastroesophageal reflux disease – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/gastroesophageal-reflux-disease/

  Reduce or avoid triggering substances: Tobacco, alcohol, and/or caffeine if the patient experiences correlation with symptoms, Medications that may worsen symptoms (e.g., CCBs, diazepam). […] Antireflux surgery may be considered for select patients after careful evaluation. Predictors of successful outcomes include: Symptoms that correlate objectively with reflux episodes using ambulatory esophageal pH monitoring, Prior good response to PPIs. […] Indications: Discontinuation of medical therapy (e.g., due to nonadherence or side effects), Symptoms refractory to medical therapy, Complications despite optimal medical therapy, e.g., severe esophagitis, strictures, recurrent aspiration, Large hiatal hernia.

• #84 Management of Gastroesophageal Reflux Disease | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/1001/p1311.html

  If a patient who was initially started on twice-daily H2RA therapy does not respond after two weeks, appropriate step-up therapy is to switch to once-daily PPI therapy. […] Evidence also indicates that step-up therapy and step-down therapy are cost-effective and should be used. […] Consideration of antireflux surgery must be individualized. Indications for surgery include failed medical management, patient preference for surgery despite successful medical management, complications of GERD, medical complications attributable to a large hiatal hernia, or atypical symptoms with reflux documented on 24-hour pH monitoring. […] The goals of radiofrequency heating of the gastroesophageal junction (Stretta procedure) and endoscopic gastroplasty (endocinch procedure) are to reduce medication use, improve quality of life, and decrease reflux symptoms in patients who have GERD, without the costs and risks associated with conventional antireflux surgery.

• #85 Gastroesophageal reflux disease – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/gastroesophageal-reflux-disease/

  Reduce or avoid triggering substances: Tobacco, alcohol, and/or caffeine if the patient experiences correlation with symptoms, Medications that may worsen symptoms (e.g., CCBs, diazepam). […] Antireflux surgery may be considered for select patients after careful evaluation. Predictors of successful outcomes include: Symptoms that correlate objectively with reflux episodes using ambulatory esophageal pH monitoring, Prior good response to PPIs. […] Indications: Discontinuation of medical therapy (e.g., due to nonadherence or side effects), Symptoms refractory to medical therapy, Complications despite optimal medical therapy, e.g., severe esophagitis, strictures, recurrent aspiration, Large hiatal hernia.

• #86 Gastroesophageal reflux disease – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/gastroesophageal-reflux-disease/

  Reduce or avoid triggering substances: Tobacco, alcohol, and/or caffeine if the patient experiences correlation with symptoms, Medications that may worsen symptoms (e.g., CCBs, diazepam). […] Antireflux surgery may be considered for select patients after careful evaluation. Predictors of successful outcomes include: Symptoms that correlate objectively with reflux episodes using ambulatory esophageal pH monitoring, Prior good response to PPIs. […] Indications: Discontinuation of medical therapy (e.g., due to nonadherence or side effects), Symptoms refractory to medical therapy, Complications despite optimal medical therapy, e.g., severe esophagitis, strictures, recurrent aspiration, Large hiatal hernia.

• #87 Gastroesophageal reflux disease – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/gastroesophageal-reflux-disease/

  Reduce or avoid triggering substances: Tobacco, alcohol, and/or caffeine if the patient experiences correlation with symptoms, Medications that may worsen symptoms (e.g., CCBs, diazepam). […] Antireflux surgery may be considered for select patients after careful evaluation. Predictors of successful outcomes include: Symptoms that correlate objectively with reflux episodes using ambulatory esophageal pH monitoring, Prior good response to PPIs. […] Indications: Discontinuation of medical therapy (e.g., due to nonadherence or side effects), Symptoms refractory to medical therapy, Complications despite optimal medical therapy, e.g., severe esophagitis, strictures, recurrent aspiration, Large hiatal hernia.

• #88 Gastroesophageal reflux disease – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/gastroesophageal-reflux-disease/

  Reduce or avoid triggering substances: Tobacco, alcohol, and/or caffeine if the patient experiences correlation with symptoms, Medications that may worsen symptoms (e.g., CCBs, diazepam). […] Antireflux surgery may be considered for select patients after careful evaluation. Predictors of successful outcomes include: Symptoms that correlate objectively with reflux episodes using ambulatory esophageal pH monitoring, Prior good response to PPIs. […] Indications: Discontinuation of medical therapy (e.g., due to nonadherence or side effects), Symptoms refractory to medical therapy, Complications despite optimal medical therapy, e.g., severe esophagitis, strictures, recurrent aspiration, Large hiatal hernia.

• #89 Management of gastroesophageal reflux disease (GERD) – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/management-of-gastroesophageal-reflux-disease-gerd/

  20. AGA strongly recommends that when a patient with an esophageal GERD syndrome is responsive to, but intolerant of, acid suppressive therapy, antireflux surgery should be recommended as an alternative. […] 21. AGA recommends antireflux surgery for patients with an esophageal GERD syndrome with persistent troublesome symptoms, especially troublesome regurgitation, despite PPI therapy. The potential benefits of antireflux surgery should be weighed against the deleterious effect of new symptoms consequent from surgery, particularly dysphagia, flatulence, an inability to belch, and postsurgery bowel symptoms. […] 22. AGA recommends against antireflux surgery for patients with an esophageal syndrome with or without tissue damage who are symptomatically well controlled on medical therapy. […] 23. AGA recommends against antireflux surgery as an antineoplastic measure in patients with Barrett’s metaplasia.

• #90 Management of gastroesophageal reflux disease (GERD) – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/management-of-gastroesophageal-reflux-disease-gerd/

  16. AGA recommends against less than daily dosing of PPI therapy as maintenance therapy in patients with an esophageal syndrome who previously had erosive esophagitis. […] 17. AGA recommends acute or maintenance therapy with once- or twice-daily PPIs (or H2RAs) for patients with a suspected extraesophageal GERD syndrome (laryngitis, asthma) with a concomitant esophageal GERD syndrome. […] 18. AGA recommends endoscopy with biopsy for patients with an esophageal GERD syndrome with troublesome dysphagia. Biopsies should target any areas of suspected metaplasia, dysplasia, or in the absence of any visual abnormalities, normal mucosa (at least five samples to evaluate for eosinophilic esophagitis). […] 19. AGA strongly recommends that when antireflux surgery and PPI therapy are judged to offer similar efficacy in a patient with an esophageal GERD syndrome, PPI therapy should be recommended as initial therapy because of superior safety.

• #91 Gastroesophageal Reflux Disease (GERD) – UChicago Medicine

  https://www.uchicagomedicine.org/conditions-services/esophageal-diseases/gastroesophageal-reflux-disease

  If you have GERD, you have a higher risk for Barretts esophagus. People with this condition can develop a rare type of esophageal cancer. […] If you have GERD and your symptoms still bother you even though you take medication, you may be a candidate for surgery. […] Surgery can be offered to all patients with GERD, but should be strongly considered for patients that do not experience relief of symptoms with medications. […] Anti-reflux surgery is very effective for treating gastroesophageal reflux disease. […] Our expert surgeons at UChicago Medicine with specialized training in minimally invasive techniques use high definition laparoscopy and advanced robotic technology, making anti-reflux surgery a very safe and effective treatment option. […] Fundoplication has been the standard operation for GERD treatment for nearly 50 years. […] The LINX System is a new treatment option for patients with GERD. […] Gastric bypass surgery may be an option in a select group of patients that have other medical conditions in addition to reflux. […] One of the latest options for GERD is called transoral incisionless fundoplication (TIF).

• #92 GERD: A practical approach | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/4/223

  If lifestyle interventions fail, drug treatment options are PPIs, histamine 2 receptor antagonists (H2RAs), and antacids. […] PPIs are considered the therapy of choice for symptomatic relief and healing of erosive esophagitis. […] After the initial 8-week course of therapy, most patients with GERD should attempt to take the lowest dose required to manage their symptoms. […] If first-line therapy fails, PPIs have immensely changed the landscape of treatment for GERD since their introduction, but up to 40% of patients with GERD find partial or no symptom relief with first-line therapies. […] Alternative therapies are being investigated, but none have consistently shown significant benefits over placebo. […] Indications for the procedure are presence of a large hiatal hernia, reflux esophagitis or GERD symptoms refractory to medical therapy, or adverse effects of medical therapy. […] The Linx procedure (magnetic sphincter augmentation; Torax Medical Inc., Shoreview, MN) is a minimally invasive alternative. It involves laparoscopic insertion of a band of magnetic beads around the LES, which allows passage of food and then closes to prevent acid reflux.

• #93 Gastroesophageal reflux disease – Wikipedia

  https://en.wikipedia.org/wiki/Gastroesophageal_reflux_disease

  Weight loss is recommended for the overweight or obese, as well as avoidance of bedtime snacks or lying down immediately after meals (meals should occur at least 23 hours before bedtime), elevation of the head of the bed on 6-inch blocks, avoidance of smoking, and avoidance of tight clothing that increases pressure in the stomach. […] Although moderate exercise may improve symptoms in people with GERD, vigorous exercise may worsen them. Breathing exercises may relieve GERD symptoms. […] The standard surgical treatment for severe GERD is the Nissen fundoplication. In this procedure, the upper part of the stomach is wrapped around the lower esophageal sphincter to strengthen the sphincter and prevent acid reflux and to repair a hiatal hernia. […] It is recommended only for those who do not improve with PPIs.

• #94 Gastroesophageal Reflux Disease (GERD) – UChicago Medicine

  https://www.uchicagomedicine.org/conditions-services/esophageal-diseases/gastroesophageal-reflux-disease

  If you have GERD, you have a higher risk for Barretts esophagus. People with this condition can develop a rare type of esophageal cancer. […] If you have GERD and your symptoms still bother you even though you take medication, you may be a candidate for surgery. […] Surgery can be offered to all patients with GERD, but should be strongly considered for patients that do not experience relief of symptoms with medications. […] Anti-reflux surgery is very effective for treating gastroesophageal reflux disease. […] Our expert surgeons at UChicago Medicine with specialized training in minimally invasive techniques use high definition laparoscopy and advanced robotic technology, making anti-reflux surgery a very safe and effective treatment option. […] Fundoplication has been the standard operation for GERD treatment for nearly 50 years. […] The LINX System is a new treatment option for patients with GERD. […] Gastric bypass surgery may be an option in a select group of patients that have other medical conditions in addition to reflux. […] One of the latest options for GERD is called transoral incisionless fundoplication (TIF).

• #95 GERD: A practical approach | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/4/223

  If lifestyle interventions fail, drug treatment options are PPIs, histamine 2 receptor antagonists (H2RAs), and antacids. […] PPIs are considered the therapy of choice for symptomatic relief and healing of erosive esophagitis. […] After the initial 8-week course of therapy, most patients with GERD should attempt to take the lowest dose required to manage their symptoms. […] If first-line therapy fails, PPIs have immensely changed the landscape of treatment for GERD since their introduction, but up to 40% of patients with GERD find partial or no symptom relief with first-line therapies. […] Alternative therapies are being investigated, but none have consistently shown significant benefits over placebo. […] Indications for the procedure are presence of a large hiatal hernia, reflux esophagitis or GERD symptoms refractory to medical therapy, or adverse effects of medical therapy. […] The Linx procedure (magnetic sphincter augmentation; Torax Medical Inc., Shoreview, MN) is a minimally invasive alternative. It involves laparoscopic insertion of a band of magnetic beads around the LES, which allows passage of food and then closes to prevent acid reflux.

• #96 Gastroesophageal Reflux Disease (GERD) – UChicago Medicine

  https://www.uchicagomedicine.org/conditions-services/esophageal-diseases/gastroesophageal-reflux-disease

  If you have GERD, you have a higher risk for Barretts esophagus. People with this condition can develop a rare type of esophageal cancer. […] If you have GERD and your symptoms still bother you even though you take medication, you may be a candidate for surgery. […] Surgery can be offered to all patients with GERD, but should be strongly considered for patients that do not experience relief of symptoms with medications. […] Anti-reflux surgery is very effective for treating gastroesophageal reflux disease. […] Our expert surgeons at UChicago Medicine with specialized training in minimally invasive techniques use high definition laparoscopy and advanced robotic technology, making anti-reflux surgery a very safe and effective treatment option. […] Fundoplication has been the standard operation for GERD treatment for nearly 50 years. […] The LINX System is a new treatment option for patients with GERD. […] Gastric bypass surgery may be an option in a select group of patients that have other medical conditions in addition to reflux. […] One of the latest options for GERD is called transoral incisionless fundoplication (TIF).

• #97 Gastroesophageal Reflux Disease (GERD) – UChicago Medicine

  https://www.uchicagomedicine.org/conditions-services/esophageal-diseases/gastroesophageal-reflux-disease

  If you have GERD, you have a higher risk for Barretts esophagus. People with this condition can develop a rare type of esophageal cancer. […] If you have GERD and your symptoms still bother you even though you take medication, you may be a candidate for surgery. […] Surgery can be offered to all patients with GERD, but should be strongly considered for patients that do not experience relief of symptoms with medications. […] Anti-reflux surgery is very effective for treating gastroesophageal reflux disease. […] Our expert surgeons at UChicago Medicine with specialized training in minimally invasive techniques use high definition laparoscopy and advanced robotic technology, making anti-reflux surgery a very safe and effective treatment option. […] Fundoplication has been the standard operation for GERD treatment for nearly 50 years. […] The LINX System is a new treatment option for patients with GERD. […] Gastric bypass surgery may be an option in a select group of patients that have other medical conditions in addition to reflux. […] One of the latest options for GERD is called transoral incisionless fundoplication (TIF).

• #98 Treatment for GER & GERD – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/treatment

  Your doctor may recommend that you make lifestyle changes and take medicines to manage symptoms of gastroesophageal reflux (GER) or gastroesophageal reflux disease (GERD). […] Lifestyle changes may reduce your symptoms. Your doctor may recommend losing weight if you’re overweight or have obesity, elevating your head during sleep by placing a foam wedge or extra pillows under your head and upper back to incline your body and raise your head off your bed 6 to 8 inches, quitting smoking, if you smoke, changing your eating habits and diet. […] Your doctor may prescribe one or more medicines to treat GERD. […] Your doctor may recommend surgery if your GERD symptoms don’t improve with lifestyle changes and medicines, or if you wish to stop taking long-term GERD medicines to manage symptoms. […] If you have GERD and obesity, your doctor may recommend weight-loss surgery, most often gastric bypass surgery. Weight-loss surgery can help you lose weight and reduce GERD symptoms.

• #99 Gastroesophageal Reflux Disease (GERD) – UChicago Medicine

  https://www.uchicagomedicine.org/conditions-services/esophageal-diseases/gastroesophageal-reflux-disease

  If you have GERD, you have a higher risk for Barretts esophagus. People with this condition can develop a rare type of esophageal cancer. […] If you have GERD and your symptoms still bother you even though you take medication, you may be a candidate for surgery. […] Surgery can be offered to all patients with GERD, but should be strongly considered for patients that do not experience relief of symptoms with medications. […] Anti-reflux surgery is very effective for treating gastroesophageal reflux disease. […] Our expert surgeons at UChicago Medicine with specialized training in minimally invasive techniques use high definition laparoscopy and advanced robotic technology, making anti-reflux surgery a very safe and effective treatment option. […] Fundoplication has been the standard operation for GERD treatment for nearly 50 years. […] The LINX System is a new treatment option for patients with GERD. […] Gastric bypass surgery may be an option in a select group of patients that have other medical conditions in addition to reflux. […] One of the latest options for GERD is called transoral incisionless fundoplication (TIF).

• #100 Refractory Gastroesophageal Reflux Disease: Diagnosis and Management

  https://www.jnmjournal.org/view.html?uid=1890&vmd=Full

  Alternative classes of antisecretory medications may have benefit as adjunctive therapy in refractory GERD. […] In patients with objective evidence of refractory GERD and persistent symptoms despite optimization of medical therapy, invasive surgical, or endoscopic anti-reflux interventions are options. […] When conclusive GERD evidence exists, laparoscopic ARS has demonstrated long-term efficacy comparable to PPI therapy in several randomized trials. […] Persistent esophageal symptoms despite seemingly adequate acid suppressive therapy is the starting point for evaluation to determine if GERD evidence exists. Refractory GERD is diagnosed when abnormal reflux metrics persist on endoscopy and/or pH impedance monitoring performed on optimized GERD therapy in patients with previously proven GERD.

• #101 Gastroesophageal Reflux Disease (GERD) – UChicago Medicine

  https://www.uchicagomedicine.org/conditions-services/esophageal-diseases/gastroesophageal-reflux-disease

  If you have GERD, you have a higher risk for Barretts esophagus. People with this condition can develop a rare type of esophageal cancer. […] If you have GERD and your symptoms still bother you even though you take medication, you may be a candidate for surgery. […] Surgery can be offered to all patients with GERD, but should be strongly considered for patients that do not experience relief of symptoms with medications. […] Anti-reflux surgery is very effective for treating gastroesophageal reflux disease. […] Our expert surgeons at UChicago Medicine with specialized training in minimally invasive techniques use high definition laparoscopy and advanced robotic technology, making anti-reflux surgery a very safe and effective treatment option. […] Fundoplication has been the standard operation for GERD treatment for nearly 50 years. […] The LINX System is a new treatment option for patients with GERD. […] Gastric bypass surgery may be an option in a select group of patients that have other medical conditions in addition to reflux. […] One of the latest options for GERD is called transoral incisionless fundoplication (TIF).

• #102 Five lifestyle factors that can help prevent gastroesophageal reflux disease – Harvard Health

  https://www.health.harvard.edu/blog/five-lifestyle-factors-that-can-help-prevent-gastroesophageal-reflux-disease-202105122454

  Gastroesophageal reflux disease (GERD) is a common condition in which the reflux of stomach contents into the esophagus causes troublesome symptoms or complications. […] Despite the overall safety and effectiveness of antireflux medications, concerns over their use have led to increased interest in lifestyle factors that can be helpful in managing GERD. Many common-sense lifestyle interventions are frequently recommended for preventing and treating GERD, but for many of these interventions, specific data supporting their effectiveness is lacking. […] The study authors identified five lifestyle factors that predicted which study participants were less likely to develop GERD. These five factors were: normal body weight (body mass index between 18.5 and 25), never smoking, moderate to vigorous physical activity for at least 30 minutes daily, no more than two cups of coffee/tea/soda daily, and a healthy diet (comparatively higher intake of fruits, vegetables, whole grains, legumes, poultry, and fish). […] This study adds to an increasing body of evidence suggesting that lifestyle interventions may play a significant role in preventing GERD. […] Lifestyle interventions and antireflux medications will thus continue to play important complementary roles in GERD management moving forward.

• #103 Gastroesophageal Reflux Disease: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/0301/p1161.html

  Gastroesophageal reflux disease (GERD) is a chronic, relapsing condition with associated morbidity and an adverse impact on quality of life. […] Management includes lifestyle modifications and pharmacologic therapy; refractory disease requires surgery. […] The ultimate goal of treatment is to minimize exposure of the esophagus to refluxate, thereby alleviating symptoms, healing the esophagus, preventing complications and maintaining remission. […] Lifestyle modifications are a key component in the management of GERD and should be incorporated into all treatment stages. Modifications include elevating the head of the bed by six inches, decreasing fat intake, stopping smoking, reducing alcohol consumption, losing weight, avoiding recumbency for three hours postprandially and not consuming large meals and certain types of food.

• #104 The Stages of GERD | Cooper University Health Care

  https://www.cooperhealth.org/services/gastroesophageal-reflux-disease-gerd/stages-of-gerd

  Receiving the appropriate treatment for your particular stage of GERD is important for keeping your condition from getting worse. […] Working with your doctor on a treatment plan that aligns with your stage of GERD will help manage your symptoms and halt the progression of the condition. […] Following a diet developed with a specialist will help treat symptoms and halt the progression of GERD. […] Those who have stage 2 GERD should consider consulting with a specialist who is knowledgeable about their condition. […] Stage 3 GERD is often not able to be controlled with medications. Those in this category are at risk of developing serious complications of GERD and should be cared for by a GERD specialist. […] This stage of GERD requires care by a specialist who will perform diagnostic and/or surveillance endoscopy as well as advanced esophageal manometry and pH testing. Treatment may include surgery or cancer treatment if esophageal cancer is found. […] Because GERD can worsen over time if not properly treated, an early evaluation by a specialist is recommended. A specialist will determine the stage of your GERD and work with you on an appropriate plan to treat your symptoms and minimize any risk of complications from long-term GERD.

• #105 Standards of Care for GERD

  https://www.uspharmacist.com/article/standards-of-care-for-gerd

  Before making pharmacologic recommendations to patients asking for advice on treating their GERD symptoms, it is important to consider lifestyle modifications. Patients may be under the impression that pharmacologic treatment is the only option for GERD, or some patients may be more interested in nonmedication options to help control symptoms. In any case, lifestyle modifications can improve symptoms considerably when combined with other options. […] The strongest evidence for lifestyle modifications supports weight loss and head-of-bed elevation. Weight loss is associated with improvement of GERD symptoms, especially for patients who have a BMI 25 or have experienced recent weight gain. […] Patients will vary in their responses to the cessation of some or all of these agents; therefore, recommendations can be personalized based on their reported triggers.

• #106 Acid Reflux & GERD: Symptoms, What It Is, Causes, Treatment

  https://my.clevelandclinic.org/health/diseases/17019-acid-reflux-gerd

  Some people find they can reduce acid reflux with lifestyle adjustments, like changing their eating habits, reducing alcohol and tobacco and losing weight. Healthcare providers encourage this approach. […] If you have severe GERD or it causes complications that medicine can’t help, you might need surgery. But surgery is usually minor and effective. It’s worth treating GERD to prevent its complications. […] To help manage acid reflux at home, try: Eating smaller meals. Larger meals expand your stomach and put pressure on your LES. Smaller meals digest faster and don’t stimulate your stomach to produce so much acid. […] Quitting smoking and drinking. Both tobacco and alcohol weaken your LES. They also affect your stomach, making it more acidic and slowing your digestion time. […] If you have acid reflux frequently, talk to a healthcare provider. It’s important to find out how it’s affecting your body. GERD isn’t just an inconvenience – it can do real harm. It’s also very treatable.

• #107 Acid Reflux and GERD: Causes, Treatment and Symptoms

  https://www.aarp.org/health/conditions-treatments/info-2021/acid-reflux-and-gerd.html

  Lifestyle changes can be very effective for those with mild to moderate acid reflux, says Pichetshote. Start with these tweaks and see if they help. […] Avoid certain foods. To find what triggers your acid reflux, Mohan recommends keeping a food journal that includes what you eat and any symptoms that flare up afterwards. […] Eat regularly throughout the day. Overeating is never a good idea, but an empty stomach can cause problems, too. Go more than three to four hours without chowing down and stomach acid collects. Eat small meals and drink water throughout the day. […] Don’t eat before bed. Nocturnal acid reflex is a real concern. […] Elevate your head six to eight inches by buying a wedge pillow or slipping a wedge-shaped piece of foam underneath your mattress. […] Drop some pounds. Obesity or overeating can also up your chances of having GERD by increasing your intragastric (stomach) pressure. […] Hit the gym. Being active can help with reflux as well. […] Don’t down meds without water. Certain medications among them, aspirin and ibuprofen, bisphosphonates to prevent bone loss, and some antibiotics can worsen reflux-related heartburn.

• #108 Patient education: Gastroesophageal reflux disease in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/gastroesophageal-reflux-disease-in-adults-beyond-the-basics

  Obesity – People who are obese or overweight have an increased risk of GERD and hiatal hernia. While the reasons for this are not completely understood, it is partially related to increased pressure in the abdomen. […] Pregnancy – Many women experience acid reflux during pregnancy. This usually resolves after delivery, and complications are rare. […] Lifestyle factors and medications – Some foods (including fatty foods, chocolate, and peppermint), caffeine, alcohol, and cigarette smoking can all exacerbate acid reflux and GERD. Certain medications also increase the risk. […] GERD TREATMENT […] GERD treatment is adjusted to match the frequency and severity of GERD symptoms and/or complications. […] Lifestyle changes – Certain lifestyle and dietary changes can often help relieve symptoms of GERD. If you have mild symptoms, you can try these approaches before seeking medical attention. If your symptoms are more serious, it’s a good idea to talk to your health care provider before making any changes, so they can advise you on how to incorporate these approaches into your treatment plan.

• #109

  https://journals.lww.com/ajg/fulltext/2022/01000/acg_clinical_guideline_for_the_diagnosis_and.14.aspx

  For patients with GERD who require maintenance therapy with PPIs, the PPIs should be administered in the lowest dose that effectively controls GERD symptoms and maintains healing of reflux esophagitis (conditional recommendation, low level of evidence). […] We recommend against routine addition of medical therapies in PPI nonresponders (conditional recommendation, moderate level of evidence). […] We recommend maintenance PPI therapy indefinitely or antireflux surgery for patients with LA grade C or D esophagitis (strong recommendation, moderate level of evidence). […] We do not recommend baclofen in the absence of objective evidence of GERD (strong recommendation, moderate level of evidence). […] We recommend against treatment with a prokinetic agent of any kind for GERD therapy unless there is objective evidence of gastroparesis (strong recommendation, low level of evidence). […] We do not recommend sucralfate for GERD therapy except during pregnancy (strong recommendation, low level of evidence). […] We suggest on-demand or intermittent PPI therapy for heartburn symptom control in patients with NERD (conditional recommendation, low level of evidence).

• #110 Gastroesophageal Reflux Disease | Specialized Treatment of Severe Acid Reflux – Cleveland, Ohio | University Hospitals

  https://www.uhhospitals.org/services/digestive-health-services/conditions-and-treatments/esophageal-disease/conditions-and-treatments/gerd

  Gastroesophageal reflux disease (GERD) is a severe form of acid reflux that can cause symptoms of persistent heartburn, chest pain and difficulty swallowing. […] If you are experiencing persistent heartburn or other symptoms of GERD, dont delay your care. […] Our experienced team of specialists offer innovative diagnostics for all stages of GERD. […] The diagnostic tests for GERD are similar to those for esophageal reflux and these will help your esophagus doctor confirm the extent of your gastroesophageal reflux disease. […] People who come to University Hospitals have access to a comprehensive GERD treatment options that is right for each individuals needs, which may include prescription medications or minimally invasive treatment procedures. […] Our specially trained digestive health nurses and certified digestive health dietitians work with patients to help them fully understand how to live with GERD.

• #111 The Stages of GERD | Cooper University Health Care

  https://www.cooperhealth.org/services/gastroesophageal-reflux-disease-gerd/stages-of-gerd

  Receiving the appropriate treatment for your particular stage of GERD is important for keeping your condition from getting worse. […] Working with your doctor on a treatment plan that aligns with your stage of GERD will help manage your symptoms and halt the progression of the condition. […] Following a diet developed with a specialist will help treat symptoms and halt the progression of GERD. […] Those who have stage 2 GERD should consider consulting with a specialist who is knowledgeable about their condition. […] Stage 3 GERD is often not able to be controlled with medications. Those in this category are at risk of developing serious complications of GERD and should be cared for by a GERD specialist. […] This stage of GERD requires care by a specialist who will perform diagnostic and/or surveillance endoscopy as well as advanced esophageal manometry and pH testing. Treatment may include surgery or cancer treatment if esophageal cancer is found. […] Because GERD can worsen over time if not properly treated, an early evaluation by a specialist is recommended. A specialist will determine the stage of your GERD and work with you on an appropriate plan to treat your symptoms and minimize any risk of complications from long-term GERD.

• #112 The Stages of GERD | Cooper University Health Care

  https://www.cooperhealth.org/services/gastroesophageal-reflux-disease-gerd/stages-of-gerd

  Receiving the appropriate treatment for your particular stage of GERD is important for keeping your condition from getting worse. […] Working with your doctor on a treatment plan that aligns with your stage of GERD will help manage your symptoms and halt the progression of the condition. […] Following a diet developed with a specialist will help treat symptoms and halt the progression of GERD. […] Those who have stage 2 GERD should consider consulting with a specialist who is knowledgeable about their condition. […] Stage 3 GERD is often not able to be controlled with medications. Those in this category are at risk of developing serious complications of GERD and should be cared for by a GERD specialist. […] This stage of GERD requires care by a specialist who will perform diagnostic and/or surveillance endoscopy as well as advanced esophageal manometry and pH testing. Treatment may include surgery or cancer treatment if esophageal cancer is found. […] Because GERD can worsen over time if not properly treated, an early evaluation by a specialist is recommended. A specialist will determine the stage of your GERD and work with you on an appropriate plan to treat your symptoms and minimize any risk of complications from long-term GERD.

• #113 Acid Reflux/GERD | ACG

  https://gi.org/topics/acid-reflux/

  GERD can result in serious complications including severe chest pain that can mimic a heart attack, esophageal stricture (a narrowing or obstruction of the esophagus), bleeding, or a pre-cancerous change in the lining of the esophagus called Barrett’s esophagus. […] Treatment should be designed to eliminate symptoms, heal irritation of the esophagus and prevent the long-term complications of GERD. In most patients outside of significant lifestyle changes such as weight loss, GERD is a chronic disease. As such, long-term maintenance treatment to control symptoms and prevent complications may be necessary. […] In order to decrease the amount of gastric contents that reach the esophagus, certain simple guidelines should be followed: Raise the Head of the Bed. Use an under-mattress foam wedge to elevate the head about 6-10 inches. Pillows are not an effective alternative for elevating the head in preventing reflux.

• #114 Gastroesophageal Reflux Disease (GERD) (for Teens) | Nemours KidsHealth

  https://kidshealth.org/en/teens/gerd.html

  Gastroesophageal reflux disease (GERD) is when someone has reflux more than twice a week. It’s a more serious condition than GER. Doctors usually treat it with medicine. […] Treatment for GERD depends on how severe symptoms are. For some people, treatment may just include lifestyle changes, such as changing what they eat or drink. Others will need to take medicines. In very rare cases, when GERD is particularly severe, a doctor will recommend surgery. […] These lifestyle changes can help ease the symptoms of GERD or even prevent the condition: quitting smoking, avoiding alcohol, losing weight if you are overweight, eating small meals, wearing loose-fitting clothes, avoiding carbonated beverages, avoiding foods that trigger reflux. […] Early diagnosis and treatment can help reduce or even stop uncomfortable GERD symptoms. Untreated GERD can cause permanent damage to the esophagus.

• #115 Acid Reflux/GERD | ACG

  https://gi.org/topics/acid-reflux/

  GERD can result in serious complications including severe chest pain that can mimic a heart attack, esophageal stricture (a narrowing or obstruction of the esophagus), bleeding, or a pre-cancerous change in the lining of the esophagus called Barrett’s esophagus. […] Treatment should be designed to eliminate symptoms, heal irritation of the esophagus and prevent the long-term complications of GERD. In most patients outside of significant lifestyle changes such as weight loss, GERD is a chronic disease. As such, long-term maintenance treatment to control symptoms and prevent complications may be necessary. […] In order to decrease the amount of gastric contents that reach the esophagus, certain simple guidelines should be followed: Raise the Head of the Bed. Use an under-mattress foam wedge to elevate the head about 6-10 inches. Pillows are not an effective alternative for elevating the head in preventing reflux.

• #116 Acid Reflux/GERD | ACG

  https://gi.org/topics/acid-reflux/

  GERD can result in serious complications including severe chest pain that can mimic a heart attack, esophageal stricture (a narrowing or obstruction of the esophagus), bleeding, or a pre-cancerous change in the lining of the esophagus called Barrett’s esophagus. […] Treatment should be designed to eliminate symptoms, heal irritation of the esophagus and prevent the long-term complications of GERD. In most patients outside of significant lifestyle changes such as weight loss, GERD is a chronic disease. As such, long-term maintenance treatment to control symptoms and prevent complications may be necessary. […] In order to decrease the amount of gastric contents that reach the esophagus, certain simple guidelines should be followed: Raise the Head of the Bed. Use an under-mattress foam wedge to elevate the head about 6-10 inches. Pillows are not an effective alternative for elevating the head in preventing reflux.

• #117 Acid Reflux/GERD | ACG

  https://gi.org/topics/acid-reflux/

  GERD can result in serious complications including severe chest pain that can mimic a heart attack, esophageal stricture (a narrowing or obstruction of the esophagus), bleeding, or a pre-cancerous change in the lining of the esophagus called Barrett’s esophagus. […] Treatment should be designed to eliminate symptoms, heal irritation of the esophagus and prevent the long-term complications of GERD. In most patients outside of significant lifestyle changes such as weight loss, GERD is a chronic disease. As such, long-term maintenance treatment to control symptoms and prevent complications may be necessary. […] In order to decrease the amount of gastric contents that reach the esophagus, certain simple guidelines should be followed: Raise the Head of the Bed. Use an under-mattress foam wedge to elevate the head about 6-10 inches. Pillows are not an effective alternative for elevating the head in preventing reflux.

• #118 Acid Reflux/GERD | ACG

  https://gi.org/topics/acid-reflux/

  GERD can be improved with lifestyle changes but often requires medicines for complete management. If you are using over-the-counter medications two or more times a week, or are still having symptoms despite taking daily medicines, you need to see your doctor. […] The preventative strategy is to treat GERD. If it goes untreated and cancer does develop, the survival rate for esophageal cancer, at this time, is dismal. […] With effective treatment, using the range of prescription medications and other treatments available today, you can become symptom free, avoid potential complications and restore the quality of life you deserve.

• #119 Gastroesophageal Reflux Disease (GERD) – UChicago Medicine

  https://www.uchicagomedicine.org/conditions-services/esophageal-diseases/gastroesophageal-reflux-disease

  If you have GERD, you have a higher risk for Barretts esophagus. People with this condition can develop a rare type of esophageal cancer. […] If you have GERD and your symptoms still bother you even though you take medication, you may be a candidate for surgery. […] Surgery can be offered to all patients with GERD, but should be strongly considered for patients that do not experience relief of symptoms with medications. […] Anti-reflux surgery is very effective for treating gastroesophageal reflux disease. […] Our expert surgeons at UChicago Medicine with specialized training in minimally invasive techniques use high definition laparoscopy and advanced robotic technology, making anti-reflux surgery a very safe and effective treatment option. […] Fundoplication has been the standard operation for GERD treatment for nearly 50 years. […] The LINX System is a new treatment option for patients with GERD. […] Gastric bypass surgery may be an option in a select group of patients that have other medical conditions in addition to reflux. […] One of the latest options for GERD is called transoral incisionless fundoplication (TIF).

• #120 Gastroesophageal Reflux Disease (GERD) – Symptoms & Treatment | MedStar Health

  https://www.medstarhealth.org/services/gastroesophageal-reflux-disease-gerd

  Gastroesophageal reflux disease, commonly known as GERD, is a severe, chronic form of acid reflux. […] If acid reflux and heartburn are interfering with your life, its time to see a doctor specializing in GERD. […] From antacid medications and conservative therapies to minimally invasive surgery, were here to help you prevent minor heartburn from becoming a major health issue. […] Early detection and intervention can help to minimize your risk of long-term complications. […] Several lifestyle and habit modifications may improve acid reflux symptoms. Your doctor may recommend: Achieving and maintaining a healthy weight, Eating smaller meals, Avoiding eating within two hours of lying down to sleep, Quitting smoking, Minimizing caffeine, Getting active after eating to promote digestion, Avoiding citrusy, fatty, or spicy foods.

• #121 Acid Reflux/GERD | ACG

  https://gi.org/topics/acid-reflux/

  GERD can be improved with lifestyle changes but often requires medicines for complete management. If you are using over-the-counter medications two or more times a week, or are still having symptoms despite taking daily medicines, you need to see your doctor. […] The preventative strategy is to treat GERD. If it goes untreated and cancer does develop, the survival rate for esophageal cancer, at this time, is dismal. […] With effective treatment, using the range of prescription medications and other treatments available today, you can become symptom free, avoid potential complications and restore the quality of life you deserve.

• #122 Gastroesophageal Reflux Disease (GERD) (for Teens) | Nemours KidsHealth

  https://kidshealth.org/en/teens/gerd.html

  Gastroesophageal reflux disease (GERD) is when someone has reflux more than twice a week. It’s a more serious condition than GER. Doctors usually treat it with medicine. […] Treatment for GERD depends on how severe symptoms are. For some people, treatment may just include lifestyle changes, such as changing what they eat or drink. Others will need to take medicines. In very rare cases, when GERD is particularly severe, a doctor will recommend surgery. […] These lifestyle changes can help ease the symptoms of GERD or even prevent the condition: quitting smoking, avoiding alcohol, losing weight if you are overweight, eating small meals, wearing loose-fitting clothes, avoiding carbonated beverages, avoiding foods that trigger reflux. […] Early diagnosis and treatment can help reduce or even stop uncomfortable GERD symptoms. Untreated GERD can cause permanent damage to the esophagus.

• #123 Gastroesophageal Reflux Disease (GERD) | UCI Health | Orange County, CA

  https://www.ucihealth.org/medical-services/esophageal-disease/gerd

  Gastroesophageal reflux disease (GERD) affects millions of people each year, causing chronic heartburn and painful acid regurgitation. […] Early intervention can stop or even reverse the disease cycle. […] Based on the results, your doctor may recommend lifestyle changes, medications, or possibly procedures or surgery. […] Once you’re diagnosed with GERD, diet and lifestyle changes are usually recommended to help reduce pain and heartburn. These include: losing weight, eating smaller, slower meals, avoiding trigger foods and drinks, staying upright after meals, quitting smoking, raising the head of your bed. […] Our GERD experts also pioneered cTIF, a cutting-edge procedure that combines laparoscopic hiatal hernia repair with TIF in one session to fix the root cause of your GERD. […] GERD can raise your risk of esophageal cancer, which is why our team takes a comprehensive approach to address all factors and help ensure the best long-term results for you.

• #124 GERD (Acid Reflux, Heartburn) Symptoms, Treatment, Foods, Diet

  https://www.medicinenet.com/gastroesophageal_reflux_disease_gerd/article.htm

  What changes can I make to avoid GERD? If the condition is caught early on, diet and lifestyle changes can treat GERD. The following are changes recommended to get rid of symptoms: […] Avoid foods that will increase the amount of stomach acid, like caffeinated beverages. […] Avoid foods that affect the movement of the muscles in your digestive tract. This includes alcohol, coffee, and other acidic liquids. […] Lose weight if you are overweight or obese. […] Avoid foods that decrease pressure at the bottom of the esophagus. This includes peppermint and fatty foods. […] Avoid huge meals. […] Stop smoking. […] When you lay down, elevate your head. […] Wait a few hours before lying down after a meal.

• #125 Acid Reflux/GERD | ACG

  https://gi.org/topics/acid-reflux/

  GERD can be improved with lifestyle changes but often requires medicines for complete management. If you are using over-the-counter medications two or more times a week, or are still having symptoms despite taking daily medicines, you need to see your doctor. […] The preventative strategy is to treat GERD. If it goes untreated and cancer does develop, the survival rate for esophageal cancer, at this time, is dismal. […] With effective treatment, using the range of prescription medications and other treatments available today, you can become symptom free, avoid potential complications and restore the quality of life you deserve.

• #126 The Stages of GERD | Cooper University Health Care

  https://www.cooperhealth.org/services/gastroesophageal-reflux-disease-gerd/stages-of-gerd

  Receiving the appropriate treatment for your particular stage of GERD is important for keeping your condition from getting worse. […] Working with your doctor on a treatment plan that aligns with your stage of GERD will help manage your symptoms and halt the progression of the condition. […] Following a diet developed with a specialist will help treat symptoms and halt the progression of GERD. […] Those who have stage 2 GERD should consider consulting with a specialist who is knowledgeable about their condition. […] Stage 3 GERD is often not able to be controlled with medications. Those in this category are at risk of developing serious complications of GERD and should be cared for by a GERD specialist. […] This stage of GERD requires care by a specialist who will perform diagnostic and/or surveillance endoscopy as well as advanced esophageal manometry and pH testing. Treatment may include surgery or cancer treatment if esophageal cancer is found. […] Because GERD can worsen over time if not properly treated, an early evaluation by a specialist is recommended. A specialist will determine the stage of your GERD and work with you on an appropriate plan to treat your symptoms and minimize any risk of complications from long-term GERD.

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