old dietary regimen as a new lifestyle change for Gastro esophageal / reflux disease: a pilot study

Treatment of gastro esophageal reflux disease [GERD] is becoming a challenge for medical profession. Proton pump inhibitors [PPIs] are commonly recommended but many disadvantages of these drugs are being reported, particularly when used for long term. Transient lower esophageal sphincter relaxations [TLESRs] are important cause of acid reflux. Gastric distention in upper stomach is the strongest stimulus for generation of TLESRs and is aggravated by intake of food in between meals. In an earlier cases report, two meals a day with intake of only fluids in between was suggested as a remedy for GERD. Present pilot study was conducted on 20 patients with endoscopically proven reflux esophagitis [Los Angles Grade a, b or c], who followed our advice to take meal twice a day with consumption of only soft drinks [fruit juices, tea, coffee, water, etc] in between and no medication for two weeks. On 14[th] day 15 patients [75%] were free of reflux symptoms, 2 [10%] had partial improvement and 3 [15%] reported no difference. It is concluded that two meals a day with intake of only fluids in between, whenever the patient feels hungry or thirsty, is a useful dietary regimen for the management of GERD. Further investigations are needed to confirm the benefits of this physiological lifestyle change

effective and physiological lifestyle change for management of gastroesophageal reflux disease

Proton pump inhibitors [PPIs] are commonly used in the treatment of gastro-oesophageal reflux disease [GERD]. Some disadvantages of these acid- suppressing drugs circulate and patients ask for alternatives. Transient lower oesophageal sphincter relaxations [TLESRs] are important cause of reflux. Gastric distension in upper stomach are strongest stimulus for generation of TLESRs and is aggravated by intake of food in between meals. In the light of pathophysiological mechanisms it is suggested that increasing interval between meals and only soft drinks in between will reduce reflux episodes. The hypothesis was tested in 4 patients with endoscopically proven reflux oesophagitis and/or typical reflux symptoms. Three patients followed our advice to eat twice a day, with soft drinks in between. One patient had a light breakfast but increased the interval between lunch and dinner to 8 hours. All cases were relieved from repeated reflux episodes, in 1-2 weeks, without any medication