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. 1991 Feb;32(2):133–136. doi: 10.1136/gut.32.2.133

Does body posture affect the incidence and mechanism of gastro-oesophageal reflux?

N Freidin 1, R K Mittal 1, R W McCallum 1
PMCID: PMC1378793  PMID: 1864529

Abstract

We studied eight patients with gastro-oesophageal reflux disease to compare the frequency and mechanism of reflux in the upright and supine positions. Simultaneous oesophageal manometry and pH studies were performed on two separate days in each subject in the fasting and postprandial periods. The frequency of reflux tended to be higher in the upright position. The most prevalent mechanism of reflux in either position was transient relaxation of the lower oesophageal sphincter. The frequency of transient lower oesophageal sphincter relaxation was higher in the upright than in the supine position. There was no difference in the total reflux time, acid clearance time, and number of reflux episodes lasting longer than five minutes in the two positions. We suggest that daytime reflux (upright) may be as important as night time (supine) reflux in the pathogenesis of reflux oesophagitis and needs to be considered when treating patients with reflux disease.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Dent J., Dodds W. J., Friedman R. H., Sekiguchi T., Hogan W. J., Arndorfer R. C., Petrie D. J. Mechanism of gastroesophageal reflux in recumbent asymptomatic human subjects. J Clin Invest. 1980 Feb;65(2):256–267. doi: 10.1172/JCI109667. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Dodds W. J., Dent J., Hogan W. J., Helm J. F., Hauser R., Patel G. K., Egide M. S. Mechanisms of gastroesophageal reflux in patients with reflux esophagitis. N Engl J Med. 1982 Dec 16;307(25):1547–1552. doi: 10.1056/NEJM198212163072503. [DOI] [PubMed] [Google Scholar]
  3. Habibulla K. S., Ammann J. F., Collis J. L. Effects of posture in hiatus hernia as studied by oesophageal pH measurement. Thorax. 1971 Nov;26(6):689–695. doi: 10.1136/thx.26.6.689. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Hamilton J. W., Boisen R. J., Yamamoto D. T., Wagner J. L., Reichelderfer M. Sleeping on a wedge diminishes exposure of the esophagus to refluxed acid. Dig Dis Sci. 1988 May;33(5):518–522. doi: 10.1007/BF01798350. [DOI] [PubMed] [Google Scholar]
  5. Holloway R. H., Hongo M., Berger K., McCallum R. W. Gastric distention: a mechanism for postprandial gastroesophageal reflux. Gastroenterology. 1985 Oct;89(4):779–784. doi: 10.1016/0016-5085(85)90572-4. [DOI] [PubMed] [Google Scholar]
  6. Johnson L. F., DeMeester T. R. Evaluation of elevation of the head of the bed, bethanechol, and antacid form tablets on gastroesophageal reflux. Dig Dis Sci. 1981 Aug;26(8):673–680. doi: 10.1007/BF01316854. [DOI] [PubMed] [Google Scholar]
  7. Mittal R. K., McCallum R. W. Characteristics and frequency of transient relaxations of the lower esophageal sphincter in patients with reflux esophagitis. Gastroenterology. 1988 Sep;95(3):593–599. doi: 10.1016/s0016-5085(88)80003-9. [DOI] [PubMed] [Google Scholar]
  8. Mittal R. K., McCallum R. W. Characteristics of transient lower esophageal sphincter relaxation in humans. Am J Physiol. 1987 May;252(5 Pt 1):G636–G641. doi: 10.1152/ajpgi.1987.252.5.G636. [DOI] [PubMed] [Google Scholar]
  9. de Caestecker J. S., Blackwell J. N., Pryde A., Heading R. C. Daytime gastro-oesophageal reflux is important in oesophagitis. Gut. 1987 May;28(5):519–526. doi: 10.1136/gut.28.5.519. [DOI] [PMC free article] [PubMed] [Google Scholar]

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