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

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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.

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Authors and Affiliations

  1. Department of Medicine and Surgery, Tripler Army Medical Center, Honolulu, Hawaii, Washington, D.C.

    Lawrence F. Johnson MD & Tom R. DeMeester MD

  2. Department of Medicine, Walter Reed Army Medical Center, Washington, D.C.

    Lawrence F. Johnson MD & Tom R. DeMeester MD

  3. the Uniformed Services University of the Health Sciences, Washington, D.C.

    Lawrence F. Johnson MD & Tom R. DeMeester MD

Authors
  1. Lawrence F. Johnson MD
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  2. Tom R. DeMeester MD
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The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

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Johnson, L.F., DeMeester, T.R. Evaluation of elevation of the head of the bed, bethanechol, and antacid foam tablets on gastroesophageal reflux. Digest Dis Sci 26, 673–680 (1981). https://doi.org/10.1007/BF01316854

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  • DOI: https://doi.org/10.1007/BF01316854

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