Which interventions are recommended for a patient with gastroesophageal reflux disease (GERD)?

• A. High-fat diet and late meals
• B. Sedation and bed rest
• C. Weight reduction, smoking cessation, and elevating the head of the bed 6 inches
• D. Increasing caffeine intake

Answer: (C)

GERD management focuses on lifestyle changes that reduce reflux by lowering abdominal pressure and improving the barrier at the gastroesophageal junction. Losing excess weight decreases pressure pushing contents back into the esophagus, and quitting smoking helps restore the tone of the lower esophageal sphincter and reduces episodes of reflux. Elevating the head of the bed by about 6 inches uses gravity to keep stomach contents from flowing back into the esophagus during sleep, which is a common time for reflux to occur.

These measures address the mechanisms that cause GERD without requiring medication or procedures, and they are more effective for many patients than increasing fatty foods or caffeine, which can worsen reflux, or sedentary rest, which does not counteract the underlying reflux dynamics.