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Digestive Diseases and Sciences

, Volume 26, Issue 8, pp 673–680 | Cite as

Evaluation of elevation of the head of the bed, bethanechol, and antacid foam tablets on gastroesophageal reflux

  • Lawrence F. Johnson
  • Tom R. DeMeester
Original Articles

Abstract

To ascertain how elevation of the head of the bed, bethanechol, and antacid foam tablets affect gastroesophageal reflux, we used prolonged intraesophageal pH monitoring in 55 symptomatic patients. Acid exposure was separated into reflux frequency and esophageal acid clearance time and recorded during the day in the upright posture and recumbent at night. Values before and during each therapy were compared to physiologic reflux in 15 asymptomatic controls. Ten patients slept with the head of the bed elevated and had a 67% improvement in the acid clearance time (P<0.025); however, the frequency of reflux episodes remained unchanged. Twelve patients given 25 mg of bethanechol 4 times a day had a 50% decrease in recumbent acid exposure only (P<0.05), due to a trend towards decreased reflux episodes and acid clearance time. Bethanechol combined with head of bed elevation in 19 other patients decreased both reflux frequency (30%) and acid clearance time (53%, allP<0.05). Antacid foam tablets failed to significantly diminish acid exposure. Nocturnal reflux responded the best to those therapies tested.

Keywords

Public Health Foam Symptomatic Patient Gastroesophageal Reflux Upright Posture 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Digestive Disease Systems, Inc. 1981

Authors and Affiliations

  • Lawrence F. Johnson
    • 1
    • 2
    • 3
  • Tom R. DeMeester
    • 1
    • 2
    • 3
  1. 1.Department of Medicine and SurgeryTripler Army Medical CenterHonoluluWashington, D.C.
  2. 2.Department of MedicineWalter Reed Army Medical CenterWashington, D.C.
  3. 3.the Uniformed Services University of the Health SciencesWashington, D.C.

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