Not All Lifestyle Modifications Improve GERD-New Guidelines

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phil-uk
Regular Member


Date Joined Jul 2012
Total Posts : 190
   Posted 3/24/2013 5:21 PM (GMT -6)   
New treatment guidelines from the US question the validity of some lifestyle mods currently followed both in the US and UK.

"BETHESDA, Md., March 5, 2013 /PRNewswire-USNewswire/ -- New treatment guidelines on the diagnosis and management of gastroesophageal reflux disease (GERD), one of the most prevalent digestive disorders, appear in the March issue of The American Journal of Gastroenterology.

The new guidelines from the American College of Gastroenterology provide an overview of GERD and its presentation and offer clinical recommendations for the approach to diagnosis and management of this common condition, based on an assessment of the scientific evidence...

...Not All Lifestyle Modifications Improve GERD

The authors review the evidence of the effectiveness of lifestyle interventions as part of therapy for GERD, particularly the impact of dietary and other lifestyle modifications on lower esophageal sphincter pressure (LESP), esophageal pH, and GERD symptoms. They note that, "Counseling is often provided regarding weight loss, head of bed elevation, tobacco and alcohol cessation, avoidance of late-night meals, and cessation of foods that can potentially aggravate reflux symptoms including caffeine, coffee, chocolate, spicy foods, highly acidic foods such as oranges and tomatoes, and foods with high fat content." However, based on a review of the evidence, the new guidelines conclude that "routine global elimination of food that can trigger reflux (including chocolate, caffeine, alcohol, acidic and / or spicy foods) is not recommended in the treatment of GERD." However, multiple studies have demonstrated reduction in GERD symptoms with weight loss.

An evaluation of clinical trials on the effectiveness of various lifestyle modifications finds evidence in support the some of these common lifestyle modifications, yet little or no evidence for others: "Consumption of tobacco (12 trials), chocolate (2 trials), and carbonated beverages (2 trials) and right lateral decubitus position (3 trials) were shown to lower pressure of the lower esophageal sphincter (LES), whereas consumption of alcohol (16 trials), coffee and caffeine (14 trials), spicy foods (2 trials), citrus (3 trials), and fatty foods (9 trials) had no effect. There was an increase in esophageal acid exposure times with tobacco and alcohol consumption in addition to ingestion of chocolate and fatty foods. However, tobacco and alcohol cessation (4 trials) were not shown to raise LESP, improve esophageal pH, or improve GERD symptoms. In addition, there have been no studies conducted to date that have shown clinical improvement in GERD symptoms or complications associated with cessation of coffee, caffeine, chocolate, spicy foods, citrus, carbonated beverages, fatty foods, or mint. A recent systematic review concluded that there was lack of evidence that consumption of carbonated beverages causes or provokes GERD."
 
Sorry I can't get the colour back to black.
message to self, 'phil, leave the colour settings alone.'

Post Edited (phil-uk) : 3/24/2013 5:29:17 PM (GMT-6)


thegspeak
Regular Member


Date Joined Nov 2012
Total Posts : 196
   Posted 3/24/2013 6:48 PM (GMT -6)   
Can someone explain this to me?

Lilacs
Regular Member


Date Joined Jan 2013
Total Posts : 23
   Posted 3/25/2013 4:55 AM (GMT -6)   
To me it means I can have my coffee that I like.
Female age 65. Dx acid reflux, 8/12. On Prilosec for GERD. Gallbladder removed 9/12. Had weight loss going from 108 to 94lbs in one year time. Nausea and vomiting.
Height is 60 inches. Dx EE 3/13.

tracks83
Regular Member


Date Joined Mar 2008
Total Posts : 149
   Posted 3/25/2013 6:01 AM (GMT -6)   
It's funny. My gastro told me 3 years ago that there is no scientific proof that eating certain types of food are harmful to people suffering from gerd. He did say some people can tolerate certain foods than others can. An example. If I don't take my PPI's everything bothers me. I could ingest water and it feels like battery acid in my stomach. On PPI's I don't feel any discomfort but certain drinks and food I will feel acid reflux. He told me don't eat those foods that trigger it. Eat what you want but in moderation. It's unfortunate we have this disease but you still have to live.
Most of the time I feel fine. But yesterday afternoon I was craving chicken wings. I know I pay the piper when I eat them. I don't eat them often because of the discomfort. I'm paying today. Everything feels inflammed and it hurts. Eating that made me feel normal for the time it lasted. I don't make a habit out of it.

Gastricman
Regular Member


Date Joined Jan 2013
Total Posts : 294
   Posted 3/25/2013 6:38 AM (GMT -6)   
Hi phil-uk,
 
Thanks for posting this information!
 
Cheers,
 
GM :-)

sunbeam48
Veteran Member


Date Joined Jun 2011
Total Posts : 795
   Posted 3/31/2013 6:31 AM (GMT -6)   
I'm disappointed that they didn't mention quantity of food. I believe that how much you eat is far more important than what you eat.

DOGGBONES
Veteran Member


Date Joined Apr 2012
Total Posts : 707
   Posted 3/31/2013 7:16 PM (GMT -6)   
Phil,
I have often thought about that concept, however it would be nice to see a larger test group. Certain food intolerance seems to be key as for triggers, not just the usual no no list.

DOGGBONES
Veteran Member


Date Joined Apr 2012
Total Posts : 707
   Posted 4/3/2013 1:35 PM (GMT -6)   
Anyone have any thoughts on this?
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