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I need GIT diagram for Non systemic therapy of GERD management

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Non-Systemic Therapy of GERD Management - GIT Diagram
Here is your GIT diagram for the Non-Systemic Therapy of GERD Management. Below is a summary of what the diagram covers:

Non-Systemic Therapy of GERD - Key Points

1. Lifestyle Modifications (First-line for ALL patients)

  • Weight loss - reduces intra-abdominal pressure on the LES
  • Head of bed elevation (15-20 cm) - especially for nocturnal/supine reflux
  • Avoid lying down 2-3 hours after meals
  • Dietary triggers to avoid: fatty/spicy foods, chocolate, coffee, alcohol, citrus, mint
  • Smaller, more frequent meals
  • Smoking cessation - nicotine reduces LES tone
  • Avoid tight-fitting clothing - reduces abdominal pressure

2. Antacids

AgentMechanismNotes
Mg/Al hydroxideAcid neutralizationFast-acting, PRN use
Calcium carbonateAcid neutralizationMild antisecretory effect
Sodium bicarbonateRapid neutralizationAvoid in HTN/renal disease

3. Alginates (e.g., Gaviscon)

  • React with gastric acid to form a viscous gel raft that floats on gastric contents
  • Physically prevents reflux - a non-systemic barrier mechanism
  • Preferred when post-meal reflux is predominant

4. Topical/Mucosal Protectants

  • Sucralfate - polymerizes in acid to form a protective barrier over the mucosa; useful in pregnancy
  • Bismuth compounds - mucosal coating, mild cytoprotection
Step-up Approach: Lifestyle modifications + Antacids/Alginates are trialed first. If symptoms persist, systemic therapy (H2 receptor antagonists → Proton Pump Inhibitors) is added. Surgical options (fundoplication) are reserved for refractory cases or structural defects.
(Source: Sabiston Textbook of Surgery, 21st Ed.; standard GI management guidelines)

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