How to Take a Pill

Stop taking your pills the way you’ve been taking them. 

It’s the wrong way!

Or, so a new study from researchers at Johns Hopkins University says. 

The study simulated how pills and tablets dissolve in the human stomach and are released into the upper intestine.

As soon as you take a pill, it begins a long journey into your stomach, through the intestines, and finally into the bloodstream.

Because of the long, winding journey, it may take up to an hour longer for the stomach to dissolve oral medications – depending on your posture.

The researchers found that the ideal posture for the fastest absorption wasn’t sitting upright but leaning to your right.

“We were very surprised that posture had such an immense effect on the dissolution rate of a pill. I never thought about whether I was doing it right or wrong, but now I’ll definitely think about it every time I take a pill,” says Rajat Mittal, a computer scientist studying fluid dynamics at Johns Hopkins School of Medicine.

Less immediate but far more convenient than injecting medications, oral medications are absorbed into the bloodstream through the intestine. To get there, they must first pass through the stomach and the pylorus, a valve that opens and shuts during digestion.

Drug absorption has critical ramifications for how quickly painkillers take effect or how steadily medications stabilize blood pressure. There’s also the issue of finding the appropriate dosage for women as opposed to men.

Mittal and his colleagues tested four postures using their computer model of a human stomach, based on high-resolution body scan images of a 34-year-old male.

The model, called StomachSim, simulated the fluid and biomechanics of a pill moving through the digestive tract and how fast it was ejected from the stomach into the duodenum, the first part of the small intestine where absorption of nutrients begins.

Lying or leaning to the right side while taking pills meant the drugs went into the deepest part of the simulated stomach and were ‘dissolved’ twice as fast as pills taken sitting upright.

Lying on or leaning to the left side slowed dissolution up to five times longer than an upright posture, where gravity and anatomy are on the stomach’s side.

“For elderly, sedentary, or bedridden people, whether they’re turning to the left or to the right can have a huge impact,” Mittal explains.

Previous studies have also found lying on the right side quickens the rate at which the stomach empties food into the intestine and that sitting, standing, or reclining to the right also accelerates the absorption of oral drugs.

The researchers further simulated what happens to pill absorption if someone has a condition called gastroparesis, where damaged nerves or weakened stomach muscles stop or slow the stomach from emptying itself properly.

They found that even a slight reduction in the simulated digestion power of the stomach led to noticeable differences in how fast it digested and ejected a pill into the duodenum – similar to changes in posture.

Mittal says, “Posture itself has such a huge impact on it. It’s equivalent to somebody’s stomach having a very significant dysfunction as far as pill dissolution is concerned.”

How much liquid, gas, and food you have in your stomach can affect digestion too, but they didn’t model that.

“Despite these and other limitations, we have demonstrated that computational models and simulations of gastric fluid mechanics can provide useful and unique insights into the complex physiological processes that underlie drug dissolution,” the team writes.

The way your body processes medicines may also be out of your control, thanks to your genes.

In a field called pharmacogenetics, studies of genes encoding enzymes tasked with breaking down compounds shed some light on why people react to the same medications in different ways.

So while your posture evidently significantly affects how fast your body absorbs oral drugs, there’s much more at play. Your best bet for making sure medicines are effective is remembering to take the pills as prescribed in the first place.

The study was published in Physics of Fluids.

Sources:

https://www.eurekalert.org/news-releases/961853

https://www.sciencealert.com/male-dominated-clinical-trials-have-lead-to-dangerously-overmedicated-women

https://grantome.com/grant/NIH/R21-GM139073-01

https://link.springer.com/article/10.1007/BF01535951

https://link.springer.com/article/10.1007/s00228-008-0579-2

https://my.clevelandclinic.org/health/diseases/15522-gastroparesis#

https://nigms.nih.gov/education/

https://doi.org/10.1063/5.0096877

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