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Lifestyle and dietary modifications represent the first-line approach: Eat smaller, more frequent meals rather than large portions that increase gastric distension Avoid lying down for at least 23 hours after eating to reduce reflux risk Elevate the head of the bed by 68 inches using blocks or a wedge pillow Identify and avoid trigger foods such as caffeine, alcohol, chocolate, spicy foods, citrus, and high-fat meals Maintain adequate hydration throughout the day Chew food thoroughly and eat slowly to facilitate digestion Pharmacological interventions may be appropriate for persistent symptoms: Over-the-counter antacids (calcium carbonate, magnesium hydroxide) for occasional, mild symptoms H2-receptor antagonists (famotidine) for moderate symptoms Proton pump inhibitors (omeprazole, esomeprazole) for more severe or frequent reflux, typically with an initial 8-week course It is important to note that acid-suppressing medications should be used judiciously and under medical supervision

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In addition, intranasal administration offers the potential advantages of a more rapid onset of action and avoidance of first-pass metabolism [28]

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