Is there a role for lifestyle education in the management of gastro-oesophageal reflux disease?

Gastro-oesophageal reflux disease (GORD) is a common cause of morbidity, affecting 10-20% of adults. Despite taking proton pump inhibitors, a significant proportion of patients experience persistent symptoms. To review evidence for potentially modifiable lifestyle risk factors in GORD, we conducted a search using key terms of GERD/Gastroesophageal Reflux Disease, GORD/Gastro-oesophageal Reflux Disease, Dyspepsia and Heartburn. Studies were graded on the strength of evidence provided. Evidence for lifestyle issues influencing or relieving GORD symptoms is mixed. Diet, alcohol, activity, posture, smoking, obesity, sex and psychological stress/distress have been investigated. There is no conclusive evidence showing that modulating these factors is either effective or ineffective in GORD. Evidence from other chronic disease programmes show that lifestyle education interventions that include self-management strategies are highly effective in improving well-being and reducing health care costs. Patient self-management may potentially have a significant impact on GORD symptoms. Eur J Gastroenterol Hepatol 21:1229-1240 (C) 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins.