Significance of Lifestyle Intervention for Patients of Gastroesophageal Reflux Disease

Gastroesophageal Reflux Disease or GERD is a very common medical condition; which is usually chronic in nature; causes burning sensation known as heart burn due to acid reflux. Approximately 30% of adults in western population are affected by GERD and its prevalence is at increase.

As food is swallowed it passes down the throat and through the food tube or esophagus to stomach. Lower esophageal sphincter is a circular band of muscle which is present at the junction between esophagus and stomach; usually the muscle remains tightly closed except when the food or liquid is swallowed i.e. it relaxes as food or liquid passes down to stomach and then closes again. If the sphincter fails to close as it weakens; the acidic contents of the stomach can reflux back into the lower part of the esophagus causing burning sensation which is commonly refer to as heart burn. Moreover, constant reflux of acid contents of stomach can cause irritation and inflammation of the lining of esophagus.

Some of the common symptoms of the condition may include; burning sensation in the chest or heart burn which usually occurs after eating and may worsen at night, acidic taste in the back of mouth, nausea, frequent burping, chest pain, bad breath, dysphagia or difficulty in swallowing, chocking, coughing, sensation of lump in the throat, worsening of asthma symptoms and sleep disturbances etc.

Risk factors for developing GERD are; smoking, pregnancy, obesity, use of certain medications, people with hiatal hernia which occurs when an opening in the diaphragm (a muscle dividing the chest and the abdominal cavities) lets the top of stomach move up into the chest etc.

Furthermore, some factors that can aggravate the symptoms of GERD could be; eating late at night or consuming large meals, drinking certain beverages such as alcohol, coffee, fizzy drinks etc.

If GERD is left untreated it can worsen and can lead to complications such as; esophagitis which is inflammation of esophagus, respiratory problems, esophageal stricture in which scar tissue develops and narrows esophagus, Barrett’s esophagus which develops when lining of esophagus is replaced by tissue that lines the intestines and it can lead to development of cancer.

Physicians usually prescribe medications that decrease the amount of acid produced by the stomach or counteract the acid in the stomach with alkaline chemicals to help relieve the symptoms of GERD; before attempting other lines of treatments.

However, health experts may also educate patients about life style modifications which can play a vital role in controlling the symptoms of GERD. The behavioral changes which can help patients suffering through GERD may include;

*Weight control

*Consuming food in moderate amount and avoiding overeating

*Quitting cigarette smoking

*Avoiding food that may aggravate symptoms of GERD

*Avoiding late night meals

*Avoiding wearing tight clothings

*Keeping the head slightly elevated during sleep

GERD severely affects ones’ quality of life and also threatens patient’s general health. Moreover, it carries risk of several adverse outcomes and also there is wide spread use of potent medications which are acid-inhibitors that are associated with long-term side effects.

As GERD is associated with life style factors, particularly obesity and tobacco smoking, thus scientists conducted studies to assess the role of life style interventions in the treatment of GERD.

To conduct the studies literature searches were performed in PubMed (from 1946), EMBASE (from 1980), and the Cochrane Library (no start date) to October 1, 2014. Meta-analysis, systematic reviews, randomized clinical trials (RCTs), and prospective observational studies were included.

The studies enabled researchers to conclude that weight loss and tobacco smoking cessation should be recommended to patients suffering through GERD; who are obese and smoke, respectively. Furthermore, avoiding late evening meals and head-of-the-bed elevation is also found to be effective in nocturnal GERD.

REFERENCE:

Lifestyle Intervention in Gastroesophageal Reflux Disease

https://www.sciencedirect.com/science/article/abs/pii/S1542356515006357