Effect of an Anti-Reflux Bed Wedge on Gastro esophageal Reflux Symptoms and Acid Reflux

Abstract

Background and Aim: Gastro esophageal reflux disease is common in the population, with a long pharmacological and non-pharmacological treatment. One of the non-pharmacological treatments is the elevation of the head of the bed to avoid gastro esophageal reflux when the patients are in the supine position. The objective of this investigation was to evaluate the effects of two bed wedges placed over a flat mattress on symptoms and acid reflux. Patients and Methods: Two bed wedges were placed over a flat mattress, one with 18 cm depth (5.5° inclination, wedge-1) and the other with 28 cm depth (8.6° inclination, wedge-2) and evaluated the effect on symptoms and gastro esophageal reflux. The bed wedge-1 was tested in 12 patients and the bed wedge-2 in 25 patients. All patients were assessed for symptoms, and underwent upper digestive endoscopy and 48-hour pH monitoring. The pH was measured continuously 5 cm proximal to the lower esophageal sphincter for 48 hours – 24 hours on a bed wedge (18 cm or 28 cm depth) and 24 hours without a bed wedge (i.e., on a flat mattress), in a random order. Results: Both bed wedges reduced the frequency of gastro esophageal reflux symptoms in the supine position compared with the flat mattress. Bed wedge-2 caused more discomfort during the night than the wedge-1. The pH monitoring measurements were not different between the two wedges. Conclusions: The bed wedges tested reduced the frequency of symptoms, but had no effect on gastro esophageal acid reflux. The 28 cm-depth wedge caused discomfort in supine position in most its users.