Abstract
Some patients with Cystic Fibrosis (CF) report symptoms of gastroesophageal reflux (GOR) during chest physiotherapy (PT) incorporating postural drainage (PD). Positive Expiratory Pressure (PEP) therapy, in the upright position, may be less likely to induce GOR and potentially improve pulmonary function (PF).
Aims: to establish if (1) PD increases GOR; (2) a change to PEP improves PF.
Method: 30 patients with CF aged 4 months to 19 years (18 male, 12 female; mean age 9.6 years) were studied. 24 hour pH monitoring was undertaken, including 2 PT sessions incorporating head down tilt in 4 widely used PD positions. PD was subsequently changed to PEP in those with increased symptoms of GOR. PF was studied longitudinally.
Results: PD increased GOR in 19 subjects. 6 months following the change from PD to PEP there was a significant increase in mean FVC (54.5±11.2 to 75.1±13.1 percent predicted (%); p<0.001) and FEV1 (43.8±9.6 to 61.5±12.7%; p<0.001). 6 subjects studied over 2 years continued to improve PF. Annual hospital bed days decreased from a mean of 91±5 pre- to 27128 post change from PD to PEP (p<0.005).
Conclusions: PD exacerbated GOR in 19 patients with CF, but did not increase GOR in 11 subjects with normal pH studies. All patients with symptoms of GOR during PD reported increased comfort with PEP therapy
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Button, B., Heine, R., Catto-Smith, A. et al. 267 POSTORAL DRAINAGE EXACERBATES GASTRO-OESOPHAGEAL REFLUX IN PATIENTS WITH LUNG DISEASE; IS POSITIVE EXPIRATORY PRESSURE AN ALTERNATIVE?. Pediatr Res 36, 47 (1994). https://doi.org/10.1203/00006450-199407000-00267
Issue Date:
DOI: https://doi.org/10.1203/00006450-199407000-00267