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I’ve had gastroesophageal reflux disease (GERD) for years and have always been surprised about that because I don’t really have any risk factors. I’m a thin exercise fanatic and don’t eat any foods that would predispose to GERD. Thus, I read Section One of this FP Essentials, about GERD, with great interest. And, despite being physician and a long-time GERD patient, I learned a few new things.

For example, I have always thought it was best to sleep on my right side, figuring the stomach drains to the right through the pylorus. So, sleeping on the right would help the stomach drain out through the pylorus, leaving an empty stomach that cannot reflux. But guess what? Sleeping on the left is actually better. I typically also have taken proton pump inhibitors (PPIs) approximately an hour before dinner, figuring that would provide maximal protection against reflux that occurs when supine at night, rather than taking them in the morning and having PPI action wear off by nighttime. But by taking PPIs in the morning when the stomach is completely empty, PPI action lasts for approximately 48 hours.

There also is lots of other useful information in this edition. We have all had gastroenteritis at one time or another during our lives, and Section Three discusses all the new testing options and guidelines for using them. There is also lots of useful information in Sections Two and Four about new approaches to dealing with peptic ulcer and pancreatitis, respectively.

I hope you will find this edition of FP Essentials as useful and informative as I did.

Barry D. Weiss, MD, FAAFP, Medical Editor
Professor, Department Family and Community Medicine
University of Arizona College of Medicine, Tucson

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