Brief Article
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jan 21, 2013; 19(3): 362-365
Published online Jan 21, 2013. doi: 10.3748/wjg.v19.i3.362
Right recumbent position on gastric emptying of water evidenced by 13C breath testing
Masaki Sanaka, Yoshihisa Urita, Takatsugu Yamamoto, Tsuguru Shirai, Satoshi Kimura, Hitoshi Aoyagi, Yasushi Kuyama
Masaki Sanaka, Department of Medical Pharmacy, Faculty of Pharmaceutical Sciences, Josai International University, Chiba 283-8555, Japan
Masaki Sanaka, Yoshihisa Urita, Department of General Medicine and Emergency Care, School of Medicine, Toho University, Tokyo 143-8540, Japan
Takatsugu Yamamoto, Tsuguru Shirai, Satoshi Kimura, Hitoshi Aoyagi, Yasushi Kuyama, Department of Internal Medicine, School of Medicine, Teikyo University, Tokyo 173-8605, Japan
Author contributions: Sanaka M analyzed the data and wrote the paper; Sanaka M and Urita Y designed the research study; Yamamoto T, Shirai T, Kimura S, Aoyagi H and Kuyama Y performed the research.
Correspondence to: Takatsugu Yamamoto, MD, PhD, Department of Internal Medicine, School of Medicine, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan. ymmtmze@zpost.plala.or.jp
Telephone: +81-3-39641211 Fax: +81-3-53751308
Received: February 3, 2012
Revised: December 11, 2012
Accepted: December 15, 2012
Published online: January 21, 2013
Abstract

AIM: To compare the impact of the right recumbent position with the sitting position on gastric emptying of water.

METHODS: In eight healthy male volunteers, the 13C acetate breath test was performed twice to assess gastric emptying of 100 mL tap water. Subjects were seated in one test and lying on their right side in the other. In both positions, pulmonary 13CO2 exhalation curves were obtained by plotting breath data against time. Percent gastric retention curves were created by analyzing data using the Wagner-Nelson protocol.

RESULTS: No significant posture effect was found in pulmonary 13CO2 output curves (P = 0.2150), whereas a significant effect was seen in gastric retention curves (P = 0.0315). The percent retention values at 10 min and 15 min were significantly smaller when subjects were in the right recumbent position compared with the seated position (P < 0.05). Our results verified the accelerating effect of the right recumbent position on gastric emptying of non-nutritive solutions. Concerning clinical implications, this study suggests that placing patients with acute pain on their right side after oral administration of analgesic drugs in solution is justified as an effective practice for rapid pain relief. For patients with gastrointestinal reflux symptoms, sleeping in the right recumbent position may reduce nocturnal symptoms, as delayed gastric emptying can cause reflux symptoms.

CONCLUSION: Gastric emptying of water occurs more quickly when a subject lies on the right side compared with sitting.

Keywords: Gastric emptying; Breath test; Right recumbent position; Water