The influence of postural changes on gastroesophageal reflux and barrier pressure in nonfasting individuals.
There is controversy regarding optimal body positioning (i.e., head-up, head-down) in awake nonfasting individuals to minimize the risk for pulmonary aspiration of gastric contents as the result of gastroesophageal reflux (GER). In the present study, we investigated GER and intragastric-esophageal barrier pressure by means of multichannel intraluminal impedance measurement and intragastric-esophageal manometry in awake, nonfasting volunteers randomly positioned in a 20 degrees head-up position, the supine position, and a 20 degrees head-down position. No significant difference among positions was found with respect to number of GER episodes per person (0/1/1) or intragastric-esophageal barrier pressure (15.6/19.6/19.4 mm Hg). We conclude that specific body positioning is useless in the prophylaxis of GER in awake nonfasting individuals.


CONCLUSIONS
Tilting of nonfasting individuals to the head-up or head-down position recommended for prevention of regurgitation of gastric contents does not influence the frequency of gastroesophageal reflux.
Jeske
Hans-Christian
HC
*Department of Gastroenterology, †Department of Anaesthesia, Kantonsspital St. Gallen, Switzerland; ‡Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical University, Austria.
Borovicka
Jan
J
von Goedecke
Achim
A
Meyenberger
Christa
C
Heidegger
Thomas
T
Benzer
Arnulf
A
D000328:Adult; D005260:Female; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D018475:Head-Down Tilt; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D011015:Pneumonia, Aspiration / Q000517:prevention & control; D011187:Posture / Q000502:physiology*; D011312:Pressure; D016683:Supine Position / Q000502:physiology