Johns Hopkins Health Alert
Best Practices on Treating GERD With Lifestyle Changes
There are four types of treatments for gastroesophageal reflux disease or GERD: lifestyle measures, medication, surgery, and endoscopic procedures. When it comes to lifestyle measures, research from the Archives of Internal Medicine suggests that some changes are more effective than others.
Treating GERD is important. Untreated GERD can lead to serious complications, such as esophageal ulcers (nonhealing mucosal defects), esophageal strictures, Barrett’s esophagus (a disorder of the cells lining the esophageal mucosa, which may lead to cancer), and esophageal cancer.
Doctors often recommend lifestyle changes as the first-line treatment for GERD. These measures can include elevating the head of the bed during sleep, not eating late at night, and avoiding alcohol or spicy foods. However, a study reported in The Archives of Internal Medicine (Volume 166, page 965) shows that not all of these changes are helpful in relieving GERD symptoms, and some may be unnecessarily restrictive.
- Researchers looked at the results of 100 studies conducted on various lifestyle measures for GERD. Only losing weight and elevating the head of the bed showed a clear benefit in well-designed studies.
In comparison, there was little evidence to support avoiding many suspected GERD triggers, such as alcohol, caffeine, chocolate, spicy foods, citrus, carbonated beverages, fatty foods, and mint. The same was true for sleeping on your left side or avoiding food late at night.
Although there was evidence that some of these substances and practices can cause GERD symptoms, evidence was lacking that avoiding them will relieve symptoms. However, if you experience worsening GERD symptoms after eating certain foods or drinking specific beverages you should probably avoid them. In addition, you should certainly give lifestyle changes a chance before trying medication to relieve symptoms.
Posted in Digestive Health on July 13, 2009
Reviewed February 2011
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You should be checked to Obstructive Sleep Apnea because of it's known association. Treating OSA can cure GERD.
Posted by: StopSA | July 18, 2009 3:12 PM
I have dramatically reduced my problems with GERD by drinking a tablespoon of vinegar in 6-8 oz of water, every several days in the evenings. It is almost like I've been "cured!" All the doctors want to do is put you on drugs. There are better ways.
Posted by: ttaban | July 18, 2009 9:50 PM
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After many years of acid reflux, I was referred to a Gastroenterologist three years ago who diagnosed Barrett's Esophagus via endoscopy. I was put on Prevacid 30 mgm and given a sheet of foods, etc., to avoid. I studied it and, of course, most of the foods and drinks listed were also those that are beneficial for other maladies. I didn't like that at all.
The Prevacid was like a miracle drug and I've had only rare instances (one episode of GERD every few months) of reflux. I didn't avoid the items on the list as I had no reflux as a result. In fact, I was increasing the amount of red pepper (cayenne powder) on foods for its health benefits. No reaction at all.
I drink craft beers and have red wine on Sundays. My wife, a retired RN, thinks I should try to follow the dietary restrictions. I told her they don't adversely affect me, so why should I?
My only concern was this: was the Prevacid masking any reflux without symptoms? The Nurse Practitioner at the doctor's office said that shouldn't be the case. She said if I don't have any GERD symptoms, I don't have to avoid the "offending foods and drinks".
Now I read this article and it confirms my experience. I had an endoscopy a few weeks ago and am waiting on the results. In the meantime, I will enjoy tomatoes, spices, wine, and all the other "bad stuff" GERD people like me were told to avoid.
Posted by: RVN68 | July 18, 2009 8:22 AM