What lifestyle modifications should I advise to patients with peptic ulcer disease to aid in their management?

Advise patients with peptic ulcer disease to adopt the following lifestyle modifications to aid in their management:

• Lose weight if overweight or obese to improve symptoms and overall health.
• Avoid trigger foods such as coffee, chocolate, tomatoes, and fatty or spicy foods that may exacerbate symptoms.
• Eat smaller meals and have the evening meal 3–4 hours before going to bed to reduce gastric irritation.
• Stop smoking, as smoking increases gastric acid output and delays gastric emptying, worsening ulcer symptoms.
• Reduce alcohol consumption to recommended limits, since alcohol can injure the gastric mucosa.
• Assess and manage stress, anxiety, and depression which may worsen symptoms; encourage relaxation strategies and consider psychological therapies if appropriate.
• Review medications to stop or reduce use of NSAIDs and other ulcer-inducing drugs where possible, as these can impair ulcer healing.

These lifestyle measures should be offered alongside medical treatment such as proton pump inhibitors and Helicobacter pylori eradication therapy when indicated.

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