PROGNOSIS

• Most patients with GERD do well with medications, although a relapse after cessation of medical therapy is common and indicates the need for long-term maintenance therapy [23].
• Identifying the subgroup of patients who may develop the most serious complications of the disease and treating them aggressively is important. Surgery at an early stage is most likely indicated in these patients [23].

• After a laparoscopic Nissen fundoplication, symptoms resolve in approximately 92% of patients.




COUNCELLING
• Avoid alcoholic beverages.
• Avoid carbonated beverages.
• Avoid chocolate.
• Avoid citrus products and juices.
• Avoid excessive physical activity.
• Avoid raw onions.
• Avoid voluminous meals
• Elevate the head of the bed.
• Favor decaffeinated coffee.
• Lose weight (if obese).
• Quit smoking.
• Reduce coffee intake.
• Reduce fat intake.
• Sleep in the left lateral decubitus position.
• Elevate the head of the bed
• Patients taking over the counter antacids should be aware of heir side effects as
Aluminum salts
• Constipation
• Accumulation in patients with renal impairment
• Hypophosphatemia
• Osteomalacia (rare)
Calcium salts

• Constipation
• Milk-alkali syndrome with high doses
• Rebound hyperacidity (depends on dosage)
Magnesium salts


• Diarrhea
• Accumulation in patients with renal impairment
Sodium bicarbonate

• Milk-alkali syndrome with high doses and should not be taken by hypertensives and patients of heart failure
Magnesium- aluminum combinations



• Minor changes in bowel function





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