In Reply We agree with Dr Mehta and colleagues that lifestyle interventions may reduce heartburn symptoms among patients with GERD. As highlighted in our Review, there is solid evidence to advise patients with GERD to lose weight if they are obese and to abstain from smoking. However, currently available data regarding lifestyle changes are limited, and studies have often shown divergent results. Associations between dietary or beverage modifications and GERD symptoms are weak, and large population-based studies have often failed to provide reproducible results. Although the currently available medical literature is not sufficiently strong to provide general clinical recommendations, current knowledge can be used for a more individualized approach regarding lifestyle recommendations, including avoidance of dietary factors that provoke symptoms of GERD.
