Heartburn and regurgitation are common in Western societies, largely due to obesity, age-related degradation of anti-reflux mechanisms, dietary, and psychological factors. The widespread diagnosis of gastro-oesophageal reflux disease (GORD) has led to the liberal prescribing of proton pump inhibitors (PPIs) to ameliorate these symptoms. However, this strategy is unsatisfactory for reflux-like symptoms, as it equates all symptoms with a ‘disease’, ignores symptom determinants other than acid reflux, and medicalizes harmless symptoms, compounding patient fear and hypervigilance. A more holistic approach to individualized symptom management is needed, acknowledging and addressing dietary, lifestyle, and psychosocial risk factors contributing to symptoms. A Delphi-style process was used to develop 21 statements of advice for patients with reflux-like symptoms based on published evidence and expert consensus. Helping patients identify their symptom triggers can aid personalised management through identification of risk factors.
