Behavioral and dietary interventions in the treatment of gastroesophagial reflux disease – literature review
Keywords:
GERD, lifestyleAbstract
Gastroesophageal reflux disease (GERD) is a common chronic condition characterized by the reflux of gastric contents into the esophagus. Global prevalence varies between 10–25% in North America and Europe, below 5% in Asia, and 17.4% in the Republic of Moldova. Although proton pump inhibitors are the mainstay treatment, non-pharmacological methods are gaining importance due to their efficacy in symptom relief. A systematic review of the literature was conducted using databases such as PubMed, Scopus, Web of Science, Google Scholar, Mendeley, and HINARI. Keywords included „GERD”, „nonpharmacological treatment”, „lifestyle”, „diet”, „sleep hygiene” and „stress management,” covering the period 2014–2024. Key non-pharmacological measures include weight reduction in overweight or obese patients, smoking cessation, and limiting alcohol consumption. Balanced diets, such as the Mediterranean or DASH diets, small frequent meals, and avoiding late meals are recommended. Postural measures – avoiding lying down for 2–3 hours after meals and elevating the head of the bed by 10–20 cm – help prevent reflux. Moderate physical activity is beneficial, whereas intense exercise immediately after meals should be avoided. Stress reduction techniques, including mindfulness, yoga, or cognitive-behavioral therapy, contribute to symptom improvement. Patient education and counseling are essential for therapeutic adherence and early recognition of alarm signs. Weight loss, smoking and alcohol cessation, dietary adjustments, and sleep hygiene are essential non-pharmacological interventions in GERD. Postural modifications and psychobehavioral strategies can complement treatment, and their personalization reduces symptoms and the need for long-term medication.
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