Not responding to PPI. In management.

Lifestyle changes may help reduce the frequency of heartburn. Consider trying to: Maintain a healthy weight. Excess pounds put pressure on your abdomen, pushing up your stomach and causing acid to back up into your esophagus..... Avoid tight-fitting clothing. Clothes that fit tightly around your waist put pressure on your abdomen and the lower esophageal sphincter. Avoid foods and drinks that trigger heartburn. Everyone has specific triggers. Common triggers such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine may make heartburn worse. Avoid foods you know will trigger your heartburn...... Eat smaller meals. Avoid overeating by eating smaller meals..... Don't lie down after a meal. Wait at least three hours after eating before lying down or going to bed......