Body position and esophageal sphincter pressure in infants

Lower esophageal sphincter pressure was measured in infants in the supine, prone, right lateral, left lateral, and upright positions; 14 had gastroesophageal reflux and 16 did not. Position had no significant effect on pressure in either group. However, patients with reflux had significantly lower pressures in each position. The rationale for postural therapy in infants with reflux cannot be based on alterations in sphincter pressure but is more likely related to the effect of gravity on the gastric pool. Compared with roentgenograms of the upper gastrointestinal tract or esophageal manometry the one- and 24-hour pH probe tests best identified reflux in those patients who were first seen with symptoms compatible with this diagnosis.