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Kaltenbach et al used an evidence-based approach to determine the efficacy of lifestyle measures for management of gastroesophageal reflux disease (GERD). While there was physiologic evidence that tobacco, alcohol, chocolate, and high-fat meals decreased lower esophageal sphincter pressure, there was no published evidence for the efficacy of dietary measures and tobacco or alcohol cessation on esophageal pH or GERD symptoms. Head of bed elevation and left lateral decubitus position improved the overall time that the esophageal pH was less than 4.0, while weight loss improved both pH profiles and symptoms. Therefore weight loss and head of bed elevation are effective lifestyle interventions for GERD, whereas there is no evidence of improvement in GERD outcomes after dietary interventions.
In This Issue of Archives of Internal Medicine. Arch Intern Med. 2006;166(9):947. doi:https://doi.org/10.1001/archinte.166.9.947
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