September 16, 2022 – I want to tell you a story about forgetfulness and rushing, and how the combination of the two can lead to dire consequences. A few years ago, I was lying in bed about to turn off the lights when I realized I forgot to take “my pill.”
Like about 161 million other American adults, I was a prescription drug consumer at the time. With all my heart, I got up, took out the pill, and threw it back. Lazy, I didn’t bother to get a glass of water to help things go down. Instead, I immediately went back to bed, put the pillow over my head, and got ready for bed.
Within seconds, I started to feel a burning sensation in my chest. After about a minute, that burn turned into a severe pain. Not wanting to alarm my wife, I walked into the living room and for the next 30 minutes I doubled in pain. Did I have a heart attack? I called my sister who is a resident in Texas. She suggested that I take myself to the emergency room for a checkup.
If only I knew “The Duke” at the time. He could have told me how important it is that people’s body position when they swallow pills.
Who is the Duke?
Duke is a computer representation of a 34-year-old, anatomically normal human male created by computer scientists at the IT’IS Foundation. The Foundation is a non-profit organization based in Switzerland working on various healthcare technology projects. Dr. Rajat Mittal, a professor of medicine at the Johns Hopkins School of Medicine in Baltimore, used Duke to create a computer model called “StomachSim” to explore the digestive process.
Their research, published in the journalPhysics of Fluids, made some surprising findings about the kinetics of swallowing pills – the most common form of drug use worldwide.
Mittal said he chose to study the stomach because the function of most other organ systems, from the heart to the brain, has attracted a lot of attention from scientists.
The impact of gastric biomechanics on important diseases such as diabetes, obesity and gastroparesis became apparent to me,” he said. “It is clear that bioengineering in this area Research is at least 20 years behind other more “sexy” fields like cardiovascular flow, and there seems to be a good chance of impactful work. ”
Your posture may help the pill work better
Some Things that are known to affect the ability of a pill to disperse its contents into the gut are used by the body, such as the contents of the stomach (a good breakfast, a mixture of liquids like juice, milk, and coffee) and the movement of the organ walls. Tull’s group learned that Duke’s posture also played an important role.
The researchers simulated Duke’s different postures: upright, right, left, and back through computer simulations, while simultaneously Keeping all postures the same for other parts of their analysis (as mentioned above).
They found that posture determines 83% of the speed at which the pill enters the gut. The most efficient position is to the right Tilt. The least tilt is to the left, which prevents the pill from reaching the antrum or bottom of the stomach, so all dissolved drug cannot get into the duodenum, where the stomach joins the small intestine, except for traces of the dissolved drug. (Interestingly, Jews who observe Passover are advised to lean to the left at meals, as a symbol of freedom and leisure.)
If you think about the shape of the stomach, it makes sense, it looks a bit like a bean, curving from the left side of the body to the right side. Due to gravity, Your position changes the position of the pill.
In the end, researchers found that posture was just as important for pill dissolution as gastroparesis, a condition of gastroparesis .The stomach loses its ability to empty normally.
How does this help people
Mittal said the groups most likely to benefit from such studies are older adults — who take a lot of pills and are more prone to dysphagia due to age-related changes in the esophagus — and Bedridden people, who cannot easily change positions. These findings may also improve the ability to treat patients with gastroparesis, a particular problem for people with diabetes.
Duke University and Future studies with similar simulations will look at how the gastrointestinal system digests protein, carbohydrate and fatty meals, Mittal said.
Meanwhile, Mittal offers the following advice: “Stand up straight or sit up straight after taking the medicine. If you must lie down to take the medicine, stay on your back or on your right side. Avoid lying on the left side after taking the medicine. “
As for what happened to me, any gastroenterologist who has read this thinks my condition has nothing to do with the heart. Instead, I probably have a pill esophagus Esophagitis, this irritation may be caused by the drug aggravating the mucous membranes of the esophagus. Although painful, esophagitis is not life-threatening. After about an hour, the pain started to subside and the next morning I was fine, just The dull pain in my chest reminded me of my previous ordeal. (Researchers pointed to an increase in the early days of the COVID-19 pandemic, which was linked to the antibiotic doxycycline.)
And, just to be precise, my pill problem started above stomach. Hopkins study There’s nothing in the esophagus to show that the alignment of the esophagus has an effect on how the drug disperses in the gut — unless, of course, it prevents those pills from reaching the stomach in the first place.
