Elevated Right-Lateral Head Position using a Bolster Pillow as a Non Pharmacological Strategy to Prevent Gastric Acid Effects in Patients with Gastritis or Dyspepsia: A Physiological Approach Involving Parietal Cell Activity

Background and aim: Gastritis and dyspepsia often worsen during recumbency due to increased intragastric pressure and reflux, exacerbating gastric acid contact. We evaluated whether sleeping in an elevated right lateral head position with a bolster pillow reduces acid production and symptom severity in patients with gastritis or dyspepsia. Methods: An experimental study was conducted from January 2023 to February 2025 across multiple hospitals in Ajatappareng. A total of 200 diagnosed gastritis/dyspepsia patients were enrolled following ethical clearance (Poltekkes Kemenkes Makassar, EC/47832/01/2023). Patients were assigned to sleep in a 30° elevated right lateral head position using a bolster pillow every night. Gastric acid output was measured via basal and stimulated acid tests; symptom questionnaires were collected at baseline, 3 months, and end point. Results: Compared to baseline, mean basal acid output decreased by 35% (p < 0.001); peak acid output decreased by 40% (p < 0.001). Patient-reported symptom scores (pain, burning, early satiety) dropped by 50% (p < 0.001). No adverse events were observed. Conclusion: Non pharmacological elevated right lateral head positioning attenuates acid production and dyspepsia/gastritis symptoms, likely by enhancing gastric emptying, reducing gastric distension, and dampening parietal cell activation. This posture may serve as a simple, effective adjunct to standard management.