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."
Full paper here, [pdf file]
http://gi.org/wp-content/uploads/2013/0 ... h_2013.pdf
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Post Edited (phil-uk) : 3/24/2013 5:29:17 PM (GMT-6)