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Author (up) Ness-Jensen, E.; Hveem, K.; El-Serag, H.; Lagergren, J. url  doi
  Title Lifestyle Intervention in Gastroesophageal Reflux Disease Type Journal Article
  Year 2015 Publication Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association Abbreviated Journal Clin Gastroenterol Hepatol  
  Volume Issue Pages  
  Keywords Acid Regurgitation; GERD; Heartburn; Therapy; Treatment  
  Abstract BACKGROUND & AIMS: Gastroesophageal reflux disease (GERD) affects up to 30% of adults in Western populations and is increasing in prevalence. GERD is associated with lifestyle factors, particularly obesity and tobacco smoking, which also threatens the patient's general health. GERD carries the risk of several adverse outcomes and there is widespread use of potent acid-inhibitors, which are associated with long-term adverse effects. The aim of this systematic review was to assess the role of lifestyle intervention in the treatment of GERD. METHODS: Literature searches were performed in PubMed (from 1946), EMBASE (from 1980), and the Cochrane Library (no start date) to October 1, 2014. Meta-analyses, systematic reviews, randomized clinical trials (RCTs), and prospective observational studies were included. RESULTS: Weight loss was followed by decreased time with esophageal acid exposure in 2 RCTs (from 5.6% to 3.7% and from 8.0% to 5.5%), and reduced reflux symptoms in prospective observational studies. Tobacco smoking cessation reduced reflux symptoms in normal-weight individuals in a large prospective cohort study (odds ratio, 5.67). In RCTs, late evening meals increased time with supine acid exposure compared with early meals (5.2% point change), and head-of-the-bed elevation decreased time with supine acid exposure compared with a flat position (from 21% to 15%). CONCLUSIONS: Weight loss and tobacco smoking cessation should be recommended to GERD patients who are obese and smoke, respectively. Avoiding late evening meals and head-of-the-bed elevation is effective in nocturnal GERD.  
  Address Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Section of Gastrointestinal Cancer, Division of Cancer Studies, King's College London, United Kingdom  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1542-3565 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:25956834 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1719  
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