An expert committee did not even consider them to be sufficiently effective to justify a trial as initial or long-term therapy, citing a ‘remarkable lack of data in this area’ and suggesting that ‘many patients seeking medical advice have already tried lifestyle measures and antacids and found them ineffective’. However, the introduction of potent acid suppressants has rendered lifestyle measures unfashionable. GORD is traditionally managed in a stepwise fashion, beginning with modification of lifestyle factors and use of over-the-counter medications such as antacids, stepping up to potent pharmacological agents and antireflux surgery. However, recent increases in prevalence have been reported in Asian populations, suggesting that lifestyle factors may contribute to GORD development. In the Western world, GORD, defined here as at least weekly heartburn and/or acid regurgitation, has a higher prevalence of 10–20% compared with less than 5% in Asia. It is a risk factor for adenocarcinoma of the oesophagus, an increasingly prevalent malignancy in Western populations. Frequent or severe GORD symptoms are associated with work loss and impaired health-related quality of life. Typical symptoms include heartburn and acid regurgitation. Gastro-oesophageal reflux disease (GORD) is characterized by symptoms and/or mucosal damage produced by the abnormal reflux of gastric contents into the oesophagus. However, there is limited evidence for the role of avoiding alcohol and certain dietary ingredients including carbonated drinks, caffeine, fat, spicy foods, chocolate and mint. Clinical and physiological studies also suggest that some physical measures as well as modification of meal size and timing can also be beneficial.
There is recent good evidence that weight reduction and smoking cessation are beneficial in reducing GORD symptoms. These equivocal findings are partly due to methodology problems. Conflicting results existed for the association between smoking, alcohol and various dietary factors in the development of GORD. We performed a systematic review of the literature from 2005 to the present relating to the effect of these factors and their modification on GORD symptoms, physiological parameters of reflux as well as endoscopic appearances. Several lifestyle and dietary factors are commonly cited as risk factors for gastro-oesophageal reflux disease (GORD) and modification of these factors has been advocated as first-line measures for the management of GORD.
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