Upright gastroesophageal reflux disease (GERD), also known as upright reflux, is thought to be a result of increased intragastric pressure. In turn, increases in intragastric pressure lead to transient lower esophageal sphincter relaxation that causes reflux. Small uncontrolled studies have reported that diaphragmatic breathing (DB; performing inspiratory and expiratory breaths with the abdominal muscles while keeping the chest motionless) is a modality of nonpharmacological therapy in GERD. The authors conducted a single-center, randomized controlled trial to confirm the efficacy of DB in alleviating GERD. <\/p>\n\n\n\n
A total of 23 patients (confirmed by pH impedance testing) with upright GERD (mean age, 58 years; 11 men) and 10 healthy controls (mean age, 44 years; 4 men) were randomized to DB or sham therapy. Subjects were required to undergo a manometry, perform Valsalva and abdominal hollowing (to induce reflux), and then consume a pH-neutral meal. During the subsequent 20-minute postprandial observation period, they were randomized to 10 minutes of DB or sham therapy (listening to music). <\/p>\n\n\n\n
When compared to controls at baseline, GERD patients had a higher postprandial gastric pressure (12 mm Hg vs 7 mm Hg; P<\/em>=.018), but there was no significant difference in lower esophageal sphincter (LES) pressure (23 mm Hg vs 23 mm Hg; P<\/em>=.993). Compared to sham therapy, the use of DB led to a significantly higher LES pressure (42.2 mm Hg vs 23.1 mm Hg; P<\/em><.001), along with a significant decrease in postprandial reflux events, both in patients (0.36 vs 2.6; P<\/em><.001) and controls (0 vs 1.75; P<\/em><.001). During a 48-hour impedance study, the researchers noted that patients and controls randomized to DB had lower reflux on day 2 (P<\/em>=.049) and lower acid exposure in the 2-hour window after a meal on day 2 compared to day 1 (11.8 vs 5.2; P<\/em>=.015). However, there was no difference in acid exposure in the DB and sham groups on day 2 (10.2 vs 9.4; P<\/em>=.804).<\/p>\n","protected":false},"excerpt":{"rendered":" Upright gastroesophageal reflux disease (GERD), also known as upright reflux, is thought to be a result of increased intragastric pressure. In turn, increases in intragastric pressure lead to transient lower esophageal sphincter relaxation that causes reflux. Small uncontrolled studies have reported that diaphragmatic breathing (DB; performing inspiratory and expiratory breaths with the abdominal muscles while … Read more<\/a><\/p>\n","protected":false},"template":"","categories":[1768,1791],"tags":[2098,2572,2070,2573],"class_list":["post-9757","ec-news","type-ec-news","status-publish","hentry","category-asge-journal-scan","category-esophagus","tag-esophagus-2","tag-gastroesophageal-reflux-disease","tag-gerd-2","tag-les"],"_links":{"self":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news\/9757","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news"}],"about":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/types\/ec-news"}],"wp:attachment":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media?parent=9757"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/categories?post=9757"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/tags?post=9757"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}