Systematic review: the effects of carbonated beverages on gastro-oesophageal reflux disease T. JOHNSON*, L. GERSON  , T. HERSHCOVICI*, C. STAVE à & R. FASS* *The Neuroenteric Clinical Research Group, Southern Arizona VA Health Care System, Tucson, AZ, USA;  Division of Medicine and Gastro- enterology, Stanford University School of Medicine, Stanford, CA, USA; àDivision of Medicine, Stanford University, Stanford, CA, USA Correspondence to: Prof. R. Fass, University of Arizona, Southern Arizona VA Health Care System, GI Section (1-111-GI), 3601 South 6th Avenue, Tucson, AZ 85723-0001, USA. E-mail: Ronnie.Fass@va.gov Publication data Submitted 6 November 2009 First decision 29 November 2009 Resubmitted 31 December 2009 Accepted 3 January 2010 Epub Accepted Article 4 January 2010 This uncommissioned systematic review was subject to full peer-review. SUMMARY Background Carbonated beverages have unique properties that may potentially exac- erbate gastro-oesophageal reflux disease (GERD), such as high acidity and carbonation. Cessation of carbonated beverage consumption is commonly recommended as part of lifestyle modifications for patients with GERD. Aims To evaluate the relationship of carbonated beverages with oesophageal pH, oesophageal motility, oesophageal damage, GERD symptoms and GERD complications. Methods A systematic review. Results Carbonated beverage consumption results in a very short decline in intra-oesophageal pH. In addition, carbonated beverages may lead to a transient reduction in lower oesophageal sphincter basal pressure. There is no evidence that carbonated beverages directly cause oesophageal damage. Carbonated beverages have not been consistently shown to cause GERD-related symptoms. Furthermore, there is no evidence that these popular drinks lead to GERD complications or oesophageal cancer. Conclusions Based on the currently available literature, it appears that there is no direct evidence that carbonated beverages promote or exacerbate GERD. Aliment Pharmacol Ther 31, 607–614 Alimentary Pharmacology & Therapeutics ª 2010 Blackwell Publishing Ltd 607 doi:10.1111/j.1365-2036.2010.04232.x