Manual of Clinical Nutrition

Gastroesophageal Reflux Disease (GERD)

Manual of Clinical Nutrition Management III- 41 Copyright © 2013 Compass Group, Inc.

Phase 1
Approaches Rationale
Limit food constituents that the patient claims cause
discomfort; these may include citrus fruits and
juices, tomato products, and carbonated beverages

Treat with antacids containing aluminum hydroxide
and Magnesium trisilicate (Gaviscon)

May reduce symptoms by forming a viscous barrier

in the stomach that impedes reflux

Phase 2
Approaches Rationale
Medical Approaches
 Treat with Histamine H 2 antagonists
 Cimetidine, rantidine
 Omeprazole (Prilosec)

Prescribed to decrease acidity

 Bethanechol (Urecholine)

 Metoclopramide (Reglan)

Increases LES pressure

Phase 3
Approaches Rationale
Antireflux surgery Occasional use for the patient in which maximal
medical therapy is not successful, and persistent
severe symptoms and complications are present.
Although, significant improvement is seen
postoperatively, recurrence of symptoms as well as
histologic evidence of esophagitis is reported as
time progresses (1).

Reference

1. Draganescu JM, Lipshutz WH. Esophagus, stomach, and intestines. In: Skipper A, ed. Dietitian’s Handbook of Enteral and Parenteral
   Nutrition. 2nd ed. Gaithersburg, Md: Aspen Publishers; 1998.

Bibliography
Escott-Stump S. Nutrition and Diagnosis-Related Care. 5th ed. Baltimore, Md: Williams & Wilkins; 2002.
Beyer PL. Medical nutrition therapy for upper gastrointestinal tract disorders. In: Mahan KL, Escott-Stump S, eds. Krause’s Food,
Nutrition and Diet Therapy. 10th ed. Philadelphia, Pa: WB Saunders; 2000: 650-652.
Gastroesophageal reflux disease. In: Manual of Clinical Dietetics. Chicago, Ill: American Dietetic Association; 2000.
Richter JE. A critical review of current medical therapy for gastroesophageal reflux disease. J Clin Gastroenterol. 1986;8:72-80.