The American Gastroenterological Association has issued guidelines on the management of Gastroesophageal Reflux Disease (GERD), which can be loosely described as persistent and troublesome heartburn or asymptomatic reflux that causes esophageal injury. The guidelines recommend a proton-pump inhibitor treatment (e.g. Astra Zeneca’s Nexium or TAP Pharmaceuticals’ Prevacid) — once a day, twice if necessary.

What the guidelines do not recommend is routine lifestyle changes, such as weight loss or reducing intake of coffee or alcohol. “The problem,” the authors write, is that there are “simply too many recommendations … to enforce the whole set on every patient.”

That may indeed be the case – an absence of evidence to support lifestyle changes. Do these things work? As long as the research enterprise is dominated by pharmaceutical studies, we may never know. But as long as the treatment guidelines are written by people who have financial ties to the companies selling the drugs, the public is likely to suspect their recommendations.  All three authors of the AGA guidelines are consultants to, speakers for, and/or receive research support from Astra Zeneca and TAP Pharmaceuticals, among other companies. The AGA itself receives funding from more than a dozen of the companies whose products it recommends.