Debilitating gastrointestinal symptoms may be controlled with dietary and lifestyle changes

Results from the Nurses Health Survey, one of the longest running studies on women ‘s health, show that five factors of diet and lifestyle, including regular exercise, can have a major impact on reflux. gastroesophageal (GERD) or heartburn symptoms. GERD is a common condition, affecting about one-third of the U.S. population; heartburn is the main symptom and is often controlled by medications. This new study suggests, however, that following diet and lifestyle guidelines can significantly reduce symptoms and may make medication unnecessary for some patients. Published as a cover letter JAMA Internal Medicine.

The five factors include normal weight, no smoking, moderate to vigorous physical activity for at least 30 minutes per day, limiting coffee, tea and soda to two cups per day, and diet “Sensible”.

This study provides evidence that common and debilitating gastrointestinal symptoms may be controlled in many cases by diet and lifestyle changes alone. Given the long-term health effects of GERD and serious concerns about the side effects of medications used to treat it, lifestyle should be considered as the best option for symptom control. “

Andrew T. Chan, MD, MPH, Lead Author of the Study

Chan is a gastroenterologist, head of the Clinical Epidemiology and Translational Unit at MGH, and a professor of medicine at Harvard Medical School. The lead author of the research letter is Raaj S. Mehta, MD, a gastroenterologist at MGH and Harvard Medical School.

The Nurses Health Survey II is a national survey established in 1989 and their participants return a detailed health questionnaire twice a year. It started with 116,671 participants and follow-up activity has been above 90%. This study included data from nearly 43,000 women ages 42 to 62 who were questioned about symptoms of GERD or heartburn from 2005 to 2017 – representing approximately 390,000 person-years.

The researchers created a statistical model that allowed them to work out the “population risk” for GERD symptoms associated with each of the five lifestyle factors versus reflux – in other words, they estimated the likelihood that each lifestyle feature would reduce the risk of experiencing symptoms. They found that following these guidelines could reduce GERD symptoms by 37% overall. The more specific instructions a woman follows, the lower the risk of symptoms. Among women who used common heartburn medications (proton pump protectors and H2 receptor antagonists), adhering to these guidelines also reduced symptoms.

“We were particularly interested in the effectiveness of physical activity,” says Chan. “This is one of the first studies to have shown the effectiveness of controlling GERD.” This effect, he says, may be partly due to the effect of exercise on the mobility of the digestive tract. “Being physically active may help clear up stomach acid that causes heartburn symptoms,” he says.