Gastroesophageal Reflux Management

RATIONALE:

Esophageal reflux (regurgitation of gastric contents into the esophagus) is usually prevented by contraction of the lower esophageal sphincter (valve) in normal persons.  In persons with chronic esophageal reflux, the lower esophageal sphincter may be incompetent.  Therefore, anything that decreases lower esophageal sphincter pressure may contribute to esophageal reflux in susceptible persons.  In other words, the valve between the esophagus and stomach leaks when it should not.

THERAPEUTIC RECOMMENDATIONS:

  1. Elevate the legs of the head of your bed at least six inches, preferably eight inches on blocks.
  2. Avoid eating 90 minutes to 2 hours prior to lying down. Avoid very large meals. Frequent feedings may be desirable.
  3. Avoid constricting garments.
  4. Do not smoke.
  5. Achieve and maintain your ideal body weight.
  6. Avoid the following 4 to 6 hours before retiring to bed.
    • High fat foods, fried foods, cream sauces, high fat meats and pastries. Limit use of butter, margarine, cream, oil and salad dressings.
    • Coffee, tea, decaffeinated coffee, colas, and other carbonated beverages containing caffeine.
    • Chocolate: cocoa, hot chocolate, and desserts or candies made with chocolate
    • Alcoholic beverages
    • Peppermint or spearmint
    • Other foods according to individual tolerance. (Tomatoes may be an irritant)
  7. Use an antacid at bedtime and during the night if awake. 
  8. Use medications such as Prilosec, Pepcid, Nexium, Pepcid, or other proton pump inhibitors at bedtime if prescribed
  9. Use other medical treatment if recommended by your doctor.


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