Journal Club: Diaphragmatic Breathing and GERD

Alekha Akkapeddi

Article Title: Breathing Exercises in Gastroesophageal Reflux Disease: A Systematic Review

Article Link:  https://link.springer.com/article/10.1007/s00455-022-10494-6

Authors:

Zdrhova, L., Bitnar, P., Balihar, K. et al.

Journal:  Dysphagia

Type of Research: Systematic Review

Key Takeaways:

1. Gastroesophageal reflux disease(GERD) is a complex syndrome that may have different causes. However, it is a global health population that affects our population significantly. The treatment for GERD based on current recommendations are lifestyle modifications(dietary changes, weight reduction, smoking cessation), as well as proton pump inhibitors(PPIs). However, these treatments are not long-term as they do not target the mechanisms of reflux.

2. Recently, there has been some evidence that respiratory physiotherapy can strengthen the diaphragm, and improve the antireflux barrier. Diaphragmatic breathing is part of this procedure. There is still only limited scientific data, so this is not part of a standard treatment plan.

3. Diaphragmatic breathing may be a useful therapeutic method in a large spectrum of GERD patients, including those with esophageal hypersensitivity and functional heartburn.

Actionable Steps

1. If suffering with GERD, consider respiratory physiotherapy, specifically diaphragmatic breathing in addition to a treatment plan prescribed by a doctor.

2. In cases of esophageal hypersensitivity or “functional heartburn”, breathing exercises may reduce hypersensitivity of nerves.

3. Manipulation of myofascial tissues may be a future direction to consider as it may reduce pain and improve muscle strength in the abdominal cavity.