Fast Five Quiz: Gastroesophageal Reflux Disease (GERD)

B.S. Anand, MD

Disclosures

July 29, 2021

Although lifestyle modifications are often the first-line of management in pregnant women with GERD, PPIs are generally considered safe in pregnant patients if clinically indicated. Lifestyle modifications include the following:

  • Losing weight (if overweight)

  • Avoiding alcohol, chocolate, citrus juice, tomato-based products, peppermint, coffee, and possibly the onion family

  • Avoiding large meals

  • Waiting 3 hours after a meal before lying down

  • Elevating the head of the bed by 8 inches

Sucralfate has no role in treating GERD among nonpregnant patients.

GERD therapy other than acid suppression, including prokinetic therapy and baclofen, should only be initiated after diagnostic evaluation. Prokinetic agents are somewhat effective, but only in patients with mild symptoms. Long-term use of prokinetic agents may have serious, even potentially fatal, complications and should be discouraged.

ACG guidelines suggest that surgical therapy is generally not recommended in patients with GERD who do not respond to PPI therapy. Patients with normal endoscopic findings and study results with persistent GERD symptoms while receiving PPI therapy are much less likely to respond to surgery.

Read more on the treatment of GERD.

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