Lifestyle and Behavioral Changes and acid reflux

1Lifestyle and Behavioral Changes

 In adults, lifestyle changes such as avoidance of alcohol and smoking, weight loss, and avoidance of high-fat or highly acidic meals are generally recommended as first-line therapy for treatment of typical reflux syndrome. Although it is widely accepted that many of these constitute risks for the develop-ment of GERD, there is little in the way of controlled scientific evidence to indicate their efficacy in treating GERD and its potential complications. Several reviews have been pub-lished indicating that reduction of weight in the adult popu-lation can have a major effect in the treatment of GERD.( Vandenplas Y, et al , 2009)

In children and adolescents, current high-level evidence is in-sufficient to categorically support the use of specific dietary and other conservative lifestyle managements in the treatment of GERD. However, expert opinion suggests that children and adolescents should also avoid caffeine, chocolate, carbonated beverages, and spicy foods if they produce symptoms. In overweight individuals, weight loss is recommended and the avoidance of alcohol and smoking has numerous benefits at any age above and beyond the treatment of GERD.( Vemulapalli R.2008) Beyond infancy, the efficacy of positioning (left lateral decu-bitus; elevated head of bed) has not been studied in the pediatric population and it is unclear if the benefits demonstrated in children <1 year of age can be extrapolated to older children.Furthermore, it is presently not known if any lifestyle changes have additive benefits for children and adolescents receiving pharmacologic therapy as well.( Festi D,,et al ,2009)