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GENERAL ARTICLES

The Influence of Postural Changes on Gastroesophageal Reflux and Barrier Pressure in Nonfasting Individuals

Hans-Christian Jeske, MD^*, Jan Borovicka, MD^*, Achim von Goedecke, MD, Christa Meyenberger, MD^*, Thomas Heidegger, MD, and Arnulf Benzer, MD, DEAA

*Department of Gastroenterology, Department of Anaesthesia, Kantonsspital St. Gallen, Switzerland; Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical University, Austria

Address correspondence and reprint requests to Jan Borovicka, MD, Department of Gastroenterology, Kantonsspital St. Gallen, CH-9000 St. Gallen, Switzerland. Address e-mail to jan.borovicka{at}kssg.ch.

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° head-up position, the supine position, and a 20° 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.