How do dietitians treat symptoms of gastro-oesophageal reflux disease in adults?

Abstract

Aim: The aim of the present study was to examine dietitians' use of lifestyle measures in the management of symptoms of gastro-oesophageal reflux disease (reflux).

Methods: Questionnaire data were collected by mail from dietitians on the 2001 register of Australian Accredited Practicing Dietitians (dietitians) via the Dietitians Association of Australia mailing system. Bivariate statistical tests were used to assess relationships.

Results: The response rate was 65.8% (n = 798) with 699 working in positions where they consulted patients. Of those, 56.7% did not usually see patients who presented specifically for reflux, while 30.6% saw 1–2 such patients and 12.4% saw ≥3 such patients/month. Many dietitians who conducted patient consultations saw ≥1 per month who mentioned reflux during a consultation for another condition, with 24.3% seeing >5/month. These dietitians made the following lifestyle recommendations to reduce reflux symptoms: reduce weight if overweight (92.87%), avoid eating before lying down (94.8%), elevate the head of the bed (78.6%), avoid alcohol (73.7%), avoid spicy food (77.3%) and eat a diet low in fat (79.7%). Additionally, 60.5% made further recommendations ranging from avoiding large meals, caffeine, smoking, carbonated beverages and known precipitants, to increasing protein intake and considering food sensitivity. The number of lifestyle changes that the participants recommended to their patients with reflux was positively related to the number of changes they considered effective in reducing reflux symptoms (r = 0.56; P < 0.001; n = 651).

Conclusion: The majority of dietitians recommended lifestyle modifications as treatment for reflux symptoms despite the current lack of evidence. A thorough investigation of the efficacy of this treatment appears warranted.