Patients with reflux are instructed to avoid large meals and postprandial recumbency and to limit ingestion of caffeine and ethanol. Abstinence from smoking is also important. Elevation of the head of the bed is often beneficial. Treatment can include antacids and drugs, such as cimetidine or ranitidine, that decrease gastric acid secretion. If recurrent cholecystitis is present, elective surgical therapy is usually recommended.
Nonsurgical alternatives are available for some patients with gallstone disease.
For the patient with costochondritis or other chest wall pains, analgesic or nonsteroidal anti-inflammatory drugs and reassurance are usually effective. Occasionally, it is necessary to inject the involved area with local anesthetic. When pleuritic chest pain is the result of pneumonia, the treatment focuses on the underlying infection. Anti-inflammatory agents, such as indomethacin, may aid in the control of associated pleural discomfort. When chest pain is due to pulmonary embolus, anticoagulation with heparin is promptly employed.