The presence of extraesophageal manifestations
Losing weight (if overweight)
H2 receptor antagonists (eg, ranitidine, cimetidine, famotidine, nizatidine)
Elevating the head of the bed 8 inches
Prokinetic agents (eg, aluminum hydroxide)
The presence of Barrett esophagus
Poor patient compliance with medications
Avoiding bending or stooping positions
Antacids (eg, aluminum hydroxide, magnesium hydroxide)
Refraining from ingesting food (except liquids) within 3 hours of bedtime
Proton pump inhibitors (eg, omeprazole, lansoprazole, rabeprazole, esomeprazole, pantoprazole)
Patients with symptoms that are not completely controlled by proton pump inhibitors
Avoiding alcohol, chocolate, citrus juice, and tomato-based products
Waiting 3 hours after a meal to lie down
Eating small, frequent meals rather than large meals
Patients with well-controlled reflux disease who desire definitive, one-time treatment
Young patients
