title: Use of a positional therapy device significantly improves nocturnal gastroesophageal reflux symptoms.
abstract: The aim of this study was to measure the efficacy of a positional therapy device (PTD) at reducing proton pump inhibitor (PPI) refractory nocturnal GERD symptoms. Among patients with GERD, nocturnal symptoms are very common. A recent study demonstrated a decrease in nocturnal acid exposure and reflux episodes in healthy volunteers who slept using a PTD. This is a single-center prospective trial involving patients on anti-secretory medications with continued nocturnal heartburn and regurgitation. Patients completed the Nocturnal GERD Symptom Severity and Impact Questionnaire (N-GSSIQ) and GERD health-related quality of life questionnaire (GERD-HRQL) at enrollment. Patients were instructed to sleep on the PTD for at least 6 hours a night during the two week study period; subjects continued their baseline anti-secretory medication dose. After 2 weeks, the questionnaires were repeated. A total of 27 patients (16 females and 11 males; age 57.8 ± 15.1) were recruited. After 2 weeks of PTD use, N-GSSIQ scores significantly improved from baseline, with a mean total score improvement of 39.5 (mean 57.7 [pre] vs. 18.2 [post], P < 0.001). Significant improvement from baseline was also observed for the GERD-HRQL questionnaire (29.8 vs. 16.7, P < 0.001). No adverse events were reported. At 3 months after the trial period, 91% of the subjects continued to use the PTD on a nightly basis. Use of the PTD significantly decreased nocturnal GERD symptoms and improved GERD-HRQL. The PTD was well tolerated during the study period and for 3 months after enrollment.
authors.affiliation: Department of Gastroenterology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
authors.forename: S
authors.initials: S
authors.lastname: Allampati
authors.affiliation: Department of Gastroenterology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
authors.forename: R
authors.initials: R
authors.lastname: Lopez
authors.affiliation: Department of Gastroenterology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
authors.forename: P N
authors.initials: PN
authors.lastname: Thota
authors.affiliation: Department of Gastroenterology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
authors.forename: M
authors.initials: M
authors.lastname: Ray
authors.affiliation: Department of Gastroenterology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
authors.forename: S
authors.initials: S
authors.lastname: Birgisson
authors.affiliation: Department of Gastroenterology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Gabbard
mesh_terms: D000328:Adult; D000368:Aged; D001513:Beds; D020920:Dyssomnias / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning / Q000295:instrumentation*; D011187:Posture; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D011788:Quality of Life; D012720:Severity of Illness Index; D012890:Sleep / Q000502:physiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D054328:Proton Pump Inhibitors
keywords: GERD; PPI; refractory nocturnal symptoms; sleep positioning