GERD is becoming a challenge for the medical profession: is there any remedy?

Gastroesophageal reflux disease is becoming a common and serious problem. Proton pump inhibitors are considered as drugs of choice however, long term use leads to complications. Transient lower esophageal sphincter relaxation inhibitors, i.e., gamma-aminobutyric acid B receptor agonists, baclofen, and metabotropic glutamate receptor 5 antagonists, ADX10059, were tried in resistant cases, but caused central nervous and hepatic side effects, respectively. Irregular dietary habits possess the strongest association with GERD, because intake of food in between meals aggravates gastric distention in upper stomach and generates TLESRs, triggering reflux. During fasting, migrating myoelectrical complex clears stomach of food. Considering relationship between irregular dietary habits and GERD pathophysiology, it is suggested that two regular meals a day with only fluids in between will reduce reflux and lead to healing of inflammation caused by repeated refluxes. Initially, the suggested regimen eliminated symptoms of GERD in 4 cases in 10 days. Later, in a pilot study on 20 patients of endoscopically diagnosed GERD, it benefitted 15 cases; 100% of Los Angles grade ‘a’, 66% of grade ‘b’ and 33% of grade ‘c’. Long term studies are proposed to confirm usefulness of this dietary regimen for management of GERD, alone and in combination with drugs.