What lifestyle modifications should I advise patients with dyspepsia to help alleviate their symptoms?

Lifestyle modifications to advise patients with dyspepsia include:

• Eat smaller, more frequent meals and avoid eating late at night, ideally finishing the evening meal 3–4 hours before bedtime.
• Avoid known dietary triggers such as alcohol, caffeine, coffee, chocolate, fatty and spicy foods, fruit juices, carbonated drinks, and tomatoes.
• Maintain a healthy weight and encourage weight loss if overweight or obese.
• Stop smoking, as smoking increases gastric acid output and delays gastric emptying.
• Reduce alcohol consumption to within recommended limits.
• Consider raising the head of the bed by 10–15 cm and sleeping on the left side rather than the right or supine to reduce symptoms.
• Encourage regular physical activity.
• Advise patients to keep a food diary to identify personal symptom triggers.
• Assess and manage stress, anxiety, and depression, as these may worsen symptoms; relaxation strategies and psychological therapies may be considered.
• Review medications that may exacerbate dyspepsia symptoms and consider reducing or stopping them if appropriate (e.g., calcium-channel blockers, anticholinergics, NSAIDs, aspirin, beta-blockers, corticosteroids, tricyclic antidepressants).

These lifestyle measures are recommended as first-line management to encourage self-care and may provide general health benefits, although evidence for their direct efficacy in dyspepsia symptom relief is limited or inconclusive.