HANDI

Conditions

Elevating the head of the bed for GERD

Handbook of Non-Drug Interventions (HANDI)
        1. Elevating the head of the bed for GERD

First published: May 2021

Introduction

Gastro-oesophageal reflux disease (GERD) is a common condition, for which proton pump inhibitors (PPI) are usually prescribed. PPIs are not without some safety concerns so a non-pharmacological approach that can reduce their use would be beneficial.

Intervention

Elevating the head of the bed using blocks under the legs  or wedge pillows. In the research, the elevation was 20 cm.

Indication

To relieve symptoms of GERD

Precautions

Elevating the bed is relatively safe. Adverse events, which were largely minor, included varicose vein pain and slipping down the bed.

Availability

Cheap and relatively easy to implement

Description

A systematic review reported weak evidence that elevating the head of the bed by 20 cm using bed blocks or wedge pillows can improve GERD symptoms. The intervention has been shown to have an effect on reducing acid exposure (defined as percent of total time intra-oesophageal pH remained ≤4). The trials were short (up to 6 weeks at the most) and were unblinded. The review did not report effect of the intervention on GERD medication use.

Elevating the bed appears to reduce GERD symptoms in some people and is safe, so it should be tried.

Tips and Challenges

It is reasonable to elevate the head of the bed to 10 cm initially, and if that fails after a trial of a few weeks, to increase the elevation to 20 cm for a trial of another few weeks.

Grading

Low (We have low confidence in the research evidence, ie, further research is likely to have an important impact, which may change the estimates.) A strong recommendation based on the assumption that implementation is relatively easy.

This event attracts CPD points and can be self recorded

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