The majority of patients will not respond to lifestyle changes alone. However, a trial of lifestyle modifications is warranted, especially for mild or intermittent GORD. Weight reduction (for overweight patients) and elevation of the head of the bed (for nocturnal symptoms) may be useful.[1]Katz PO, Dunbar KB, Schnoll-Sussman FH, et al. ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2022 Jan 1;117(1):27-56.
https://journals.lww.com/ajg/fulltext/2022/01000/acg_clinical_guideline_for_the_diagnosis_and.14.aspx
http://www.ncbi.nlm.nih.gov/pubmed/34807007?tool=bestpractice.com
Specific food eliminations (e.g., chocolate, caffeine, alcohol, acidic and/or spicy foods) are not routinely required unless individuals find these helpful.[1]Katz PO, Dunbar KB, Schnoll-Sussman FH, et al. ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2022 Jan 1;117(1):27-56.
https://journals.lww.com/ajg/fulltext/2022/01000/acg_clinical_guideline_for_the_diagnosis_and.14.aspx
http://www.ncbi.nlm.nih.gov/pubmed/34807007?tool=bestpractice.com
Patients should be reassured of the safety of PPIs for treatment of GORD. Clinicians and patients should use a shared decision making model to plan long-term management and possible de-escalation of therapy.[37]Yadlapati R, Gyawali CP, Pandolfino JE, et al. AGA clinical practice update on the personalized approach to the evaluation and management of GERD: expert review. Clin Gastroenterol Hepatol. 2022 May;20(5):984-94.e1.
https://www.cghjournal.org/article/S1542-3565(22)00079-9/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/35123084?tool=bestpractice.com
[103]Farrell B, Lass E, Moayyedi P, et al. Reduce unnecessary use of proton pump inhibitors. BMJ. 2022 Oct 24;379:e069211.
http://www.ncbi.nlm.nih.gov/pubmed/36280250?tool=bestpractice.com