Jill Taylor

October 18, 2004

Oct. 18, 2004 (Orlando) — A postprandial habit of lying down is associated with other unhealthy lifestyle habits as well as some gastrointestinal disorders and should be discouraged by physicians, according to a study presented here at the 17th World Conference of Family Doctors.

A habit of lying down after eating is known as a risk factor of reflux esophagitis. "We see patients with esophageal reflux disease who become more symptomatic if they lie down immediately postprandial," Stephen Spann, MD, a professor at Baylor College of Medicine in Houston, Texas, told Medscape. Dr. Spann was not involved in the research.

However, according to lead investigator Jae Ho Lee, MD, from the College of Medicine at the Catholic University of Korea, and colleagues, a relationship between gastrointestinal disorders and a postprandial habit of lying down had not yet been identified.

To investigate the relationship between this habit and lifestyle factors, and between the habit and gastrointestinal symptoms and disorders, the researchers performed a study of 1,030 patients who visited a general health screening center in Korea between January 2001 and December 2002.

The study population was divided into two groups: a frequent postprandial lying-down group (n = 576) and a group that rarely exhibited the behavior (n = 436). After frequency matching by age, sex, lifestyle factors (smoking, alcohol consumption, exercise, eating habits, nighttime sleep duration and awakening frequency, naps, and coffee intake), gastrointestinal symptoms (dyspepsia, epigastric pain, heart burn, chest pain, and constipation) and gastrofiberoscopic findings were compared.

Analysis was performed using Chi-square tests and stepwise multiple logistic regression. Factors such as gastritis and reflux esophagitis were set as dependent variables, while postprandial lying down was set as an independent variable.

The investigators found that subjects with a frequent postprandial habit of lying down showed a significantly greater degree of alcohol consumption ( P < .001), irregular eating habits ( P < .001), eating between meals ( P < .001), napping ( P < .001), and nighttime awakening frequency ( P < .016) compared with the group that rarely exhibited the habit. Chest pain ( P = .031) and constipation ( P = .010) were also more common in the frequent postprandial lying-down group.

In contrast, no differences were observed between the two groups in the prevalence of dyspepsia ( P = .147), epigastric pain ( P = .085), or heartburn ( P = .700). In the group exhibiting frequent postprandial lying down, the odds ratios for erythematous gastritis and atrophic gastritis were 1.61 ( P = .059) and 1.62 ( P = .073), respectively.

"In the office, I frequently see patients' complaints originating from bad habits," Dr. Lee told Medscape. "During patient education, I need to stress that postprandial walking or other light exercise is better than lying down."

The researchers conclude that further investigation is needed to clarify the causal relationships between a postprandial lying-down habit and gastrointestinal symptoms and disorders.

Dr. Lee did not disclose any conflicts of interest.

17th World Conference of Family Doctors: Abstract 3212. Presented Oct. 15, 2004.

Reviewed by Gary D. Vogin, MD


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