Effect of Head-of-Bed Elevation on Nocturnal Reflux Symptoms of Esophageal Cancer Patients With Esophagectomy and Reconstruction

Abstract

Studies revealed the symptom of gastroesophageal reflux (GE reflux) disturb patients following esophageal reconstruction. To examine the effect of head-of-bed elevation by using the wedge-shaped pillow (WSP) on the reflux symptoms of patients with esophageal cancer following esophagectomy and reconstruction. Fourteen patients with nocturnal reflux symptoms following esophagectomy and gastric tube reconstruction were enrolled and randomized into 2 groups. A 2-week crossover trial was performed using 2 sequences (drug only and drug plus WSP). The WSP was designed with a height of 20 cm, a length of 62 cm, and an elevation angle of 20 degrees and used with fabricated from memory foam. After 2 weeks, all of the patients received combined drug and WSP intervention for 3 months. Reflux symptoms were measured by Dysfunction After Upper Gastrointestinal Surgery for Cancer and examined by endoscopic observations prior to intervention and follow-up for 3 months. The average reflux symptom score for the combined drug and WSP treatment in the beginning 2 weeks was lower than that for the drug-only sequence. The severity of esophagitis was improved in 46.1%, and 38.5% showed a stabilization after 3 months. Combined drug and WSP treatment may be beneficial in improving GE reflux symptoms. Nursing care professionals would suggest patients find a similar WSP to elevate the head of the bed to reduce the severity of nocturnal reflux symptoms after esophagectomy and gastric tube reconstruction.