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Patients with symptomatic gastroesophageal reflux disease (GERD) are usually advised to make lifestyle modifications, such as avoiding certain substances (chocolate, mints, citrus fruits, fatty foods, carbonated beverages, tobacco, coffee, and other caffeinated products), losing weight, avoiding late-evening meals and postprandial recumbency, and sleeping on one’s left side. How much evidence is there, though, to support these recommendations?
Researchers systematically reviewed 100 studies on lifestyle factors and GERD, including 16 that specifically addressed how lifestyle changes influenced symptoms, esophageal pH, or lower esophageal sphincter pressure. Two investigators independently evaluated each study and graded the level of evidence…