Gastro-oesophageal reflux disease: Posture is important

doi:10.1136/bmj.332.7535.236-c

BMJ 2006;332:236 (28 January), doi:10.1136/bmj.332.7535.236-c

Letter

Gastro-oesophageal reflux disease

Posture is important

The first 150 words of the full text of this article appear below.

Editor—Fox and Forgacs do not mention the effects of postureon gastro-oesophageal reflux disease in their review.¹ Controlledtrials are not possible in this respect, but some weight mustbe given to the experience of many patients and doctors.

I can report on over 70 years of coming to terms with pepticulceration and over 30 years of trying to cope with severe reflux.Gross adverse reactions to the modern acid suppressants as wellas clarithromycin have forced me to rely on a postural approach,which is effective when combined with a simple antacid mixturetaken after meals and at bedtime. Patients should be advisedto avoid bending down, especially after meals. They should beencouraged to sleep in a semi-upright position.

This is achieved ideally by the use of an adjustable mattress,but such beds are expensive and not transportable. A backrestis easily improvised, but a "donkey" is . . . [Full text of this article]

Norman K Gibbon, retired consultant urologist

Liverpool L37 2EY nok-gibbon@mersinet.co.uk