Effects of Postprandial Body Position on Gastrointestinal Motility, the Autonomic Nervous System and Subjective Comfort

We examined postprandial body positions’ effects on gastrointestinal motility, the autonomic nervous system and subjective comfort, i.e., whether lowering the head after a meal is beneficial for gastrointestinal motility and the prevention of pressure ulcer. We examined 10 healthy subjects and compared 3 body positions: (1) Seated upright. (2) Lying on a bed with the head at 60° and knees up by 20° (60° position). (3) Identical to (2) until post-meal; the head was then lowered to 30° (60°-30° position). Gastrointestinal motility was assessed as gastrointestinal sounds measured by sound-editing software. Digital plethysmography assessed autonomic nerve function as heart rate variability. The pressure ulcer risk was estimated as subjective comfort/discomfort using a visual analog scale. Gastrointestinal sounds increased post-meal. The 60°-30° position showed the highest number of sounds and longest cumulative sound duration. Post-meal, sympathetic activation was suggested in the 60° position, whereas vagal activity was relatively preserved in the 60°-30° position. The 60°-30° position was the most comfortable, and the 60° position was least comfortable. Lowering the head after a meal is beneficial to augment gastrointestinal motility and decrease the pressure ulcer risk. The 60° head-up position increases the pressure ulcer risk.