GERD-Lifestyle — ESEGH MCQ
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Correct answer: A — Weight loss in overweight patients
Weight loss in overweight patients is the only nonpharmacologic intervention with robust evidence for reducing GERD severity and symptom resolution. Systematic reviews demonstrate that weight loss reduces GERD prevalence from ~37% to 15% and achieves complete symptom relief in 65% of patients, likely by reducing intra-abdominal pressure and restoring lower esophageal sphincter (LES) integrity. In contrast, targeted elimination of specific food types (including acidic foods) lacks clinical trial support despite physiological plausibility. High-fat intake is a recognized risk factor for GERD, not a treatment. Exercise, when appropriate to body weight loss, is beneficial not harmful. Lifestyle modifications remain essential even in PPI-refractory cases; elevation of the bed head at night is another evidence-based measure. Option E is incorrect as multiple interventions have proven benefit.
Reference: 1. Management of gastroesophageal reflux disease: lifestyle modification and alternative approaches. PubMed. 2014. https://pubmed.ncbi.nlm.nih.gov/24603400/; 2. Role of Non-pharmacological Interventions and Weight Loss in the Management of Gastroesophageal Reflux Disease in Obese Individuals: A Systematic Review. PMC. 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524852/