What patient education helps prevent GERD symptoms?

• A. Elevate the head of the bed at night
• B. Limit caffeine after noon
• C. Wear loose clothing
• D. Avoid large meals before bed

Answer: (D)

Avoiding large meals before bed reduces nocturnal reflux by limiting stomach distension and the amount of acid and contents that can reflux into the esophagus when someone is lying down. When the stomach is full, pressure increases and the lower esophageal sphincter may be overwhelmed, especially in a horizontal position, leading to more symptoms. Giving the stomach time to digest and choosing a lighter dinner before bedtime lowers the chance of reflux overnight and improves comfort and sleep. Other measures, like elevating the head of the bed, wearing loose clothing, or limiting caffeine, can help, but avoiding large evening meals directly reduces the reflux trigger.