What is the Best Position to Swallow Pills

Highlights:

Your posture may have an impact on how well oral drugs are absorbed
A pill can breakdown and empty into the top of the small intestine more quickly and also it is closer to the lowest region of the stomach
The drug dissolution is optimal when lying on the right side. It is the worst while lying on the left side

When taking drugs orally, it is common to consider elements that may impact how effectively they function. Factors that affect medicine absorption include whether to take the medicines with or without meals or only at specific times during the day.

But have you ever considered how your posture may impact the absorption of your medication? Are you typically in bed, seated at the breakfast table, or standing at the counter as your coffee brews while taking pills?

A recent study published in the journal Physics of Fluids suggests that how you swallow a pill impacts how well it is absorbed.

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‘A recent study using a simulated model revealed that certain body positions are more effective than others for breaking down oral drugs. However, scientists advised not altering the way of taking medicines without consulting the doctor.’

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What Affects Medicine Absorption in the Body?

Johns Hopkins University researchers discovered that when taken orally, body position and posture can significantly affect how quickly the medication is absorbed.

“If you are standing upright or you are lying down and leaning to the right, then the pill lands very close to the end region of the stomach,” said Rajat Mittal, PhD, senior author of the study and a professor of mechanical engineering at Johns Hopkins University. “As a result, it dissolves quickly. However, if you lie down and lean to the left, that is the worst possible position in terms of dissolving the pill quickly.”

The research team employed a model for the study called ‘StomachSim’, based on the realistic anatomy and structure of the stomach.

The simulator can simulate what happens within a human stomach as it breaks down food- or, in this case, medicine- using the magic of physics and biomechanics.

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Different Body Positions and Postures for Consuming Medicines

Seated or standing straight
Lying backwards
Rolled over and turned to the right
Turning to the left while lying down

The simulation demonstrated that sleeping on the right side while taking pills was ideal since it allowed the medication to reach the deepest portion of the stomach. When taken this way, the medicines disintegrated twice as quickly as when taken while seated.

Leaning to the left or lying on the left side, on the other hand, was the worst position to be in since it increased the time it took for medication absorption by up to five times.

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Does Posture Impact Medicine Absorption?

Because the stomach is asymmetrical, posture would significantly affect how pills dissolve, claimed Mittal. The stomach curls from the left to the right side of the body (it looks like a bean).

Additionally, a pill weighs slightly more than stomach contents (which Mittal pointed out is primarily made up of water).

“Because of gravity, the pill will tend to settle down towards the direction of gravity,” said Mittal. “So, depending on which way you are leaning, whether you are standing up or lying down, it can really affect where the pill lands in the stomach.”

Most medications do not begin to work until the stomach releases the capsule contents into the intestine, according to Jason Gallagher, PharmD, a clinical professor at Temple University's School of Pharmacy and a clinical pharmacy specialist in infectious diseases at Temple University Hospital.

A tablet starts to break down and releases its contents into the top of the small intestine more quickly if it falls very close to the lowest region of the stomach- roughly the exit, suggested Gallagher.

“In the stomach, it typically dilutes into a liquid and then keeps going through the gastrointestinal tract,” said Gallagher. “Most of the drug is absorbed in the small intestine for most medications. The amount of time that they spend in various parts of the GI tract can affect their absorption.”

The posture you are in when you take a tablet could alter how it travels through your GI system because of gravity and the natural unevenness of the stomach.

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Does Position Change while Consuming Pills Be Helpful?

Taking medicines while standing up or lying backwards would still be effective and provide ideal backup plans, according to Mittal, especially given that these positions are typical of elderly folks, inactive individuals, and patients who are bedridden.

“Lying back actually turns out to be not that bad,” said Mittal. “It is not as good as being upright, but it is still somewhat reasonable.”

The researchers also looked at how underactive stomachs affect the disintegration of pills to gain a better idea of how much of an impact body position may have.

In particular, the researchers simulated what occurs in gastroparesis, a disorder in which the stomach does not properly empty food. Diabetes or viral infections may be to blame for slower stomach emptying.

According to the findings, the impact of position on stomach pills was comparable to that of conditions like gastroparesis.

“When we compared how much posture affected pill dissolution and how significant gastroparesis affected pill dissolution, we found the two were very comparable,” said Mittal. “So, in some sense, the effect of posture and the dissolution of the pill is equivalent to having fairly severe gastroparesis.”

Limitations of the Study Highlighting the Importance of Posture in Medication Absorption

The study had significant limitations. One is that the researchers did not examine how different ages and sexes of people could react to the pills in their stomachs. They also did not account for other illnesses that could delay stomach emptying.

“Everybody’s stomach is different,” said Mittal, “From children, elderly, adults, men and women, all of our organs are unique in size and shape. The team wanted to keep things simple, so we assumed a single and same shape for all the different simulations.”

Mittal also said, “Some people have surgery (e.g., gastric surgery) or any other condition that completely changes how their stomach behaves. The team has not looked at such cases in their research.”

Should You Change Positions to Take Your Medicine?

According to the study, dissolving pills was most effective while one was resting on the right side. However, experts disagree that the normal person should start taking medication differently.

“I think they should change nothing at all,” said Gallagher. “We don’t need medication to be absorbed faster because it is designed in a certain way.”

Mittal added, “Pills are also designed with a normal kind of posture in mind and the normal posture that a pill is designed for is standing upright and being upright. You can be cognizant of the fact that your body posture matters, but in almost all cases, being upright will always work very well.”

Source-Medindia