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Increased oesophageal acid exposure at the beginning of the recumbent period is primarily a recumbent-awake phenomenon

2010; Wiley; Volume: 32; Issue: 6 Linguagem: Inglês

10.1111/j.1365-2036.2010.04403.x

1365-2036

Larissa M. Allen, Choo Hean Poh, Anita Gąsiorowska, Isaac Malagon, Tomás Navarro–Rodriguez, Hua Cui, Jacquelyn Powers, Bridget Moty, Marcia R. Willis, Nicole Ashpole, Stuart F. Quan, Ronnie Fass,

Dysphagia Assessment and Management

Summary Background A significant increase in oesophageal acid exposure during early recumbent period has been demonstrated. Aim To determine if acid reflux during the early recumbent period occurs in the recumbent‐asleep or recumbent‐awake period using a novel integrative actigraphy and pH programme. Method Thirty‐nine subjects with heartburn at least three times a week were included. Subjects underwent pH testing concomitantly with actigraphy. Simultaneously recorded actigraphy and pH data were incorporated using a novel integrative technique to determine sleep and awake periods. Characteristics of acid reflux were compared between the recumbent‐awake and recumbent‐asleep periods. Results Seventeen (44.7%) subjects had acid reflux events during recumbent‐awake period as compared to seven (18.4%) in the corresponding recumbent‐asleep period ( P = 0.046). The mean number of acid reflux events in recumbent‐awake period was significantly higher than in the corresponding recumbent‐asleep period (8.1 ± 4.4 vs. 3.2 ± 1.5, P < 0.001). In the recumbent‐awake period, 38.4% of acid reflux events were associated with GERD‐related symptoms as compared with 3.7% of acid reflux events during the corresponding recumbent‐asleep period ( P = 0.01). Conclusion Increased acid reflux in the early recumbent period occurs primarily during the recumbent‐awake and not during the recumbent‐asleep period.