What lifestyle modifications should I advise to patients with Barrett's oesophagus to reduce their risk of progression?

Advise patients with Barrett's oesophagus to lose weight if they are overweight or obese, as weight reduction may help reduce disease progression ¹.

Encourage smoking cessation, since smoking increases gastric acid production and delays gastric emptying, which may contribute to disease progression ¹.

Recommend avoiding trigger foods such as coffee, chocolate, tomatoes, and fatty or spicy foods, although evidence for their impact is limited ¹.

Advise patients to eat smaller meals and to have their evening meal 3–4 hours before bedtime to reduce reflux episodes ¹.

Suggest raising the head of the bed by placing wood or bricks under the bed head by 10–20 cm to decrease nocturnal acid exposure, as this may help reduce disease progression ¹.

Advise managing stress and anxiety, as psychological factors may influence disease progression, and encourage relaxation strategies ¹.