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Review: sparse evidence supports lifestyle modifications for reducing symptoms of gastro-oesophageal reflux disease

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 Q In patients with gastro-oesophageal reflux disease (GORD), what is the evidence that lifestyle factors are associated with symptoms or physiological measures of GORD and that lifestyle modification interventions can improve GORD symptoms?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★★☆ Gastroenterology ★★★★★★☆


Embedded ImageData sources:

Medline and Ovid (1975–2004).

Embedded ImageStudy selection and assessment:

English language studies of any design that evaluated the effect of lifestyle factors or modifications on physiological or clinical aspects of GORD. A standard scoring system with 5 levels of evidence was used to assess the quality of individual studies: level A, randomised controlled trials (RCTs) with consistent evidence; level B, cohort, case control, non-randomised, or uncontrolled studies; level C, case reports, flawed trials, or population studies; level D, expert opinion; level E, insufficient evidence or studies with conflicting data. 100 studies met the selection criteria, including 16 studies of lifestyle modification.

Embedded ImageOutcomes:

heartburn …

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  • For correspondence: Dr L B Gerson, Stanford University School of Medicine, Stanford, CA, USA. lgerson{at}

  • Source of funding: American Gastroenterological Association.