Lifestyle changes as a treatment of gastroesophageal reflux disease: a survey of general practitioners in North Queensland, Australia

Madeleine Nowak¹, Petra Büttner¹, Beverly Raasch², Kym Daniell², Cindy McCutchan¹, Simone Harrison¹

¹School of Public Health and Tropical Medicine, ²School of Medicine, North Queensland Centre for Cancer Research within the Australian Institute of Tropical Medicine, James Cook University, Townsville, QLD, Australia

Background: Gastroesophageal reflux disease (GERD) is a common disorder in developed countries, with the usual treatment being medication. Previously, lifestyle modification was the only treatment for GERD; however, its effectiveness has not been assessed.

Methods: All practicing general practitioner (GP) members of two Divisions of General Practice (n = 193) in North Queensland, Australia, were surveyed in 2001 using a postal questionnaire to determine their views and practices relating to such treatment among adults with GERD.

Results: The response rate was 70.5%. Of those who responded, 17.6% recommended diet and postural advice as a first line of treatment, with postural advice (89.7%), avoid known precipitants (86.0%), reduce weight if overweight (79.4%), eat a low fat diet (45.6%), and stop smoking (17.6%) being the most common recommendations. Of the nine possible changes, the median number recommended was 3, interquartile range (IQR; 3, 4). Eighty-nine percent of GPs thought ≥ 10% of patients with GERD would benefit from lifestyle changes, but almost half thought ≤ 10% of patients would be prepared to change.

Conclusion: Most GPs thought lifestyle changes would be beneficial when treating GERD, but did not believe their patients would change. Most GPs recommended fewer than half the lifestyle changes their peers believed effective in treating GERD.

Keywords: GERD, lifestyle modification, general practitioners, beliefs, food, posture