Kitchin et al. Arch Internal Med (1991).
Gastroesophageal reflux disease (GERD), also known as acid reflux disease or in mild cases heartburn, is an increasingly common condition in the developed world, characterized by frequent regurgitations of stomach acid into the lower esophagus. GERD can often be caused by a hiatal hernia, a condition where part of the stomach slips above the diaphragm to contact the esophagus. If left untreated, damage caused by severe GERD can cause replacement of the normal cells lining the esophagus by other tissue types (a condition known as Barrett’s esophagus), eventually leading to an increased risk of esophageal cancer. While acid-suppressive medications can be used, their potential side effects and complications can be avoided through a variety of simpler treatment measures. This review article finds significant clinical evidence for the efficacy of lifestyle-based treatments for heartburn and GERD, including elevation of the head of the bed.
Sleeping on a wedge diminishes exposure of the esophagus to refluxed acid. Hamilton et al. Digestive Dis Sciences (1988).
Using continuous monitoring of pH (acidity) within the esophagus among several alternative positions at rest, this randomized clinical trial detected a significant decrease in the time that the esophagus was exposed to highly acid conditions when using a foam wedge to elevate the head, and also showed a decrease in the time necessary for the acid to be cleared. Interestingly, use of a wedge-shaped mechanism was significantly more effective than elevation through the use of standard bed blocks.
Davis C. Ryman
MD/PhD candidate, Case Western Reserve University
Lamb lab,Departments of Neuroscience and Genetics