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For a patient with GERD, it is generally recommended that they avoid the use of tobacco, alcohol, chocolate, and citrus juice. Concerns associated with PPI use for GERD include failure to respond, rebound gastritis, atrophy gastritis, Helicobacter pylori or Clostridium diff infection, and other drug-induced side effects, making it a wiser choice to pursue diet change instead of taking a PPI long term. Many case studies have been done to determine the effects of different dietary changes on the symptoms of GERD.
In a small case series, “five individuals followed the standard Atkins diet, which restricts carbohydrates to 20 g daily while allowing unlimited access to protein and fat. According to patient self-reports, all five patients had a remission of GERD symptoms within one day to two weeks from the time they started the diet, and symptoms reoccurred when it was discontinued.” (Yancy W. J., et al 2001). In order to be successful, the low card diets should
“be varied and include 4-6 servings of cereals per day, 5 servings of vegetables/fruit per day, and a minimum of 2 servings of legumes per week.
Carbohydrates should contribute over 50% of total energy intake, except in individuals with hypertriglyceridemia, for whom they should contribute about 45%. Consumption of carbohydrates with a low glycemic index in the framework of dietary fiber ensures a diet with a low glycemic load. The energy contribution of simple carbohydrates should be below 10%. Consumption of fructose, as an isolated sugar, should be avoided. Total fiber intake should be between 30-40 g per day (10-13 g/1,000 kcal).
Thus, a diet of 2,000 kcal may contain about 25 g of fiber, while that of 2,500 kcal about 30 g.” (Lopez-Garcia, E., at al 2014).
According to research by Yancy W. J., et al in 2001, evidence indicates that when patients discontinue PPIs after long-term treatment, they eventually relapse. PPIs can “induce parietal cell proliferation, which leads to a state of hyperacidity after discontinuation. This rebound hyperacidity can create a dependence on continued PPI use” (Yancy W. J., et al 2001). The possibility of dependency and relapse has become a major concern among researchers and clinicians. By following the diet plan to bring the patient to a normal weight and eliminate the need for hypercholesterolemia, hypertension, and GERD medications, the patient can be unhindered by the harmful side effects and repercussions of the drugs.
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