Which of the following dietary measures would be useful in preventing esophageal reflux?
A. Eating small, frequent meals.
B. Increasing fluid intake.
C. Avoiding air swallowing with meals.
D. Adding a bedtime snack to the dietary plan.
Correct Answer: A. Eating small, frequent meals.
Esophageal reflux worsens when the stomach is overdistended with food. Therefore, an important measure is to eat small, frequent meals. Encourage small frequent meals of high calories and high protein foods. Small and frequent meals are easier to digest. Instruct the patient to eat slowly and masticate foods well to help prevent reflux.
Option B: Fluid intake should be decreased during meals to reduce abdominal distention. Avoid placing the patient in supine position, have the patient sit upright after meals. Supine position after meals can increase regurgitation of acid.
Option C: Avoiding air swallowing does not prevent esophageal reflux. Assess for pulmonary symptoms resulting from reflux of gastric content. These include subsequent aspiration, chronic pulmonary disease, or nocturnal wheezing, bronchitis, asthma, morning hoarseness, and cough.
Option D: Food intake in the evening should be strictly limited to reduce the incidence of nighttime reflux, so bedtime snacks are not recommended. Instruct the patient to avoid highly seasoned food, acidic juices, alcoholic drinks, bedtime snacks, and foods high in fat. These can reduce the lower esophageal sphincter pressure.
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