A patient with nightly reflux asks which nonpharmacologic strategy is mechanistically most likely to reduce nocturnal GERD episodes. Which option best explains the mechanism?

Sleeping on the right side to concentrate gastric secretions near the pylorus thereby improving gastric emptying and eliminating retrograde flow into the esophagus during sleep; this position directly prevents LES relaxation and is universally recommended.

Taking high‑fat meals before bed to delay gastric emptying and allow the lower esophageal sphincter to remain closed throughout the night; this reduces episodes by stabilizing intragastric pressure fluctuations and should be recommended to everyone with GERD.

Elevating the head of the bed by 15–20 cm so gravity reduces nocturnal gastric reflux into the esophagus, decreasing time acid contacts the mucosa during sleep.

Using a tight abdominal binder at night to apply external pressure to the lower chest and reinforce the diaphragmatic crura, thus mechanically preventing hiatal herniation and reflux for patients with pregnancy‑related GERD.