Diet and lifestyle modification for the management of gastro-oesophageal reflux in adults

Advise all adults with gastro-oesophageal reflux symptoms to trial diet and lifestyle modifications. In some patients—especially those with mild symptoms—these measures may be sufficient to control symptoms.

Reflux symptoms are commonly induced by high-fat meals, alcohol, coffee, chocolate, citrus fruit, tomato products, spicy foods and carbonated beverages. Limiting specific foods may improve symptoms, but this should only be continued if effective; advise patients to avoid food restrictions that do not improve symptoms.

Weight loss can be effective for improving reflux symptoms in patients who are overweight; even modest weight loss can be beneficialNess-Jensen, 2013.

Other measures include:

• eating smaller mealsStein, 2020
• eating meals slowlyStein, 2020
• avoiding lying down after eating
• avoiding eating or drinking for 2 to 3 hours before bedtime or vigorous exercise
• using a positional therapy device (eg wedge pillow) or elevating the head of the bed (if symptoms occur at night)
• stopping smokingNess-Jensen, 2013.