Effects of Head-of-Bed Elevation in Supine Nasopharyngeal Reflux

Abstract

RationaleNasopharyngeal reflux (NPR) of gastric contents can contribute to perennial nasopharyngitis, cough and asthma. However, unlike gastroesophageal reflux disease (GERD), effective treatment strategies for NPR remain inadequately defined. We hypothesized that head-of-bed elevation would improve supine NPR as it does in GERD when measured by overnight nasopharyngeal pH monitoring.MethodsA retrospective chart review was performed of patients seen at Scripps Health, Division of Allergy, Asthma and Immunology who had undergone overnight nasopharyngeal pH monitoring with a commercially available nasopharyngeal pH monitoring device, Dx-pH Measurement System from Restech, San Diego, CA. Patients were included if they had documented solely supine NPR and then underwent sequential pH monitoring before and after elevating the head of bed six inches. We performed a descriptive analysis of observed data.ResultsSequential overnight nasopharyngeal pH monitoring before and after head-of-bed elevation was obtained in 13 individuals. Ten subjects demonstrated significant improvement of supine NPR, 8 of which demonstrated complete resolution of supine NPR with six inches of head-of-bed elevation.ConclusionsThis study provides new evidence that six inches of head-of-bed elevation can be an effective means of treating supine NPR. RationaleNasopharyngeal reflux (NPR) of gastric contents can contribute to perennial nasopharyngitis, cough and asthma. However, unlike gastroesophageal reflux disease (GERD), effective treatment strategies for NPR remain inadequately defined. We hypothesized that head-of-bed elevation would improve supine NPR as it does in GERD when measured by overnight nasopharyngeal pH monitoring. Nasopharyngeal reflux (NPR) of gastric contents can contribute to perennial nasopharyngitis, cough and asthma. However, unlike gastroesophageal reflux disease (GERD), effective treatment strategies for NPR remain inadequately defined. We hypothesized that head-of-bed elevation would improve supine NPR as it does in GERD when measured by overnight nasopharyngeal pH monitoring. MethodsA retrospective chart review was performed of patients seen at Scripps Health, Division of Allergy, Asthma and Immunology who had undergone overnight nasopharyngeal pH monitoring with a commercially available nasopharyngeal pH monitoring device, Dx-pH Measurement System from Restech, San Diego, CA. Patients were included if they had documented solely supine NPR and then underwent sequential pH monitoring before and after elevating the head of bed six inches. We performed a descriptive analysis of observed data. A retrospective chart review was performed of patients seen at Scripps Health, Division of Allergy, Asthma and Immunology who had undergone overnight nasopharyngeal pH monitoring with a commercially available nasopharyngeal pH monitoring device, Dx-pH Measurement System from Restech, San Diego, CA. Patients were included if they had documented solely supine NPR and then underwent sequential pH monitoring before and after elevating the head of bed six inches. We performed a descriptive analysis of observed data. ResultsSequential overnight nasopharyngeal pH monitoring before and after head-of-bed elevation was obtained in 13 individuals. Ten subjects demonstrated significant improvement of supine NPR, 8 of which demonstrated complete resolution of supine NPR with six inches of head-of-bed elevation. Sequential overnight nasopharyngeal pH monitoring before and after head-of-bed elevation was obtained in 13 individuals. Ten subjects demonstrated significant improvement of supine NPR, 8 of which demonstrated complete resolution of supine NPR with six inches of head-of-bed elevation. ConclusionsThis study provides new evidence that six inches of head-of-bed elevation can be an effective means of treating supine NPR. This study provides new evidence that six inches of head-of-bed elevation can be an effective means of treating supine NPR.