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In addition to causing significant side effects, proton pump inhibitors (PPIs) are not very effective much of the time. PPI-refractory gastroesophageal reflux, or reflux that does not respond to drugs, affects about 30% of the patients who have GERD. Almost half of these patients report that continual belching is a problem. Belching is not only a common symptom of GERD, but it can also increase the number and severity of reflux episodes.
An interesting study showed that breathing exercises improved belching and symptoms in patients with PPI-refractory GERD. The study included patients diagnosed with GERD who also reported belching, heartburn, and/or regurgitation even after taking PPIs daily for 12 weeks. Fifteen patients were taught a standardized diaphragmatic breathing exercise protocol, while twenty-one controls were placed on a waitlist. All of the subjects completed questionnaires at the start of the study, after breathing therapy, and then 4 months after therapy ended. The 21 control patients completed an additional questionnaire after their waitlist period, and then were also given breathing therapy.
During the intervention period, 80% of the patients taught better breathing techniques had significant reductions in belching frequency, as compared to only 19% of control patients. Intervention patients also experienced significantly greater reductions in reflux symptoms and more improvement in quality of life than the controls. Patients with the worst symptoms showed the most improvement, and the positive changes were sustained at 4 months after the termination of therapy.
Diaphragmatic breathing was the method used for this intervention, and anyone can learn how to do it. It’s defined as deep breathing that involves contraction of the diaphragm, the muscle located at the base of the lungs. There are hundreds of online videos that demonstrate the practice, but here are some simple instructions:
Most people are "shallow breathers," which means that they use the upper chest to breathe. This results in overuse of muscles in the neck and upper body, and underuse of the diaphragm. Shallow breathing is exacerbated during stressful situations or when people become anxious. Regular practice can make diaphragmatic breathing, a more energizing and restorative form of breathing, the default method. One way to get more practice is to take yoga classes, which almost always include a focus on breathing.
Most of us do not think about breathing much because we do it naturally. But learning better breathing techniques can improve your health in many ways.
Ong AML, Chua LTT, Khor CJL, Asokkumar R, Namasivayam V, Wang YT. "Diaphragmatic Breathing Reduces Belching and Proton Pump Inhibitor Refractory Gastroesophageal Reflux Symptoms." Clin Gastroentol Hepatol 2018 Mar;16(3):407-416.e2
An interesting study showed that breathing exercises improved belching and symptoms in patients with PPI-refractory GERD. The study included patients diagnosed with GERD who also reported belching, heartburn, and/or regurgitation even after taking PPIs daily for 12 weeks. Fifteen patients were taught a standardized diaphragmatic breathing exercise protocol, while twenty-one controls were placed on a waitlist. All of the subjects completed questionnaires at the start of the study, after breathing therapy, and then 4 months after therapy ended. The 21 control patients completed an additional questionnaire after their waitlist period, and then were also given breathing therapy.
During the intervention period, 80% of the patients taught better breathing techniques had significant reductions in belching frequency, as compared to only 19% of control patients. Intervention patients also experienced significantly greater reductions in reflux symptoms and more improvement in quality of life than the controls. Patients with the worst symptoms showed the most improvement, and the positive changes were sustained at 4 months after the termination of therapy.
Diaphragmatic breathing was the method used for this intervention, and anyone can learn how to do it. It’s defined as deep breathing that involves contraction of the diaphragm, the muscle located at the base of the lungs. There are hundreds of online videos that demonstrate the practice, but here are some simple instructions:
Just place one hand on your upper chest and the other on your belly just below the rib cage. Breathe in slowly and deeply, while your chest remains relatively still and your belly rises. Your rib cage may expand as well. Then exhale through your mouth while contracting the abdominal muscles. The belly should return to its original position.
In addition to helping with GERD, deep breathing can slow the heartbeat, lower blood pressure, and reduce stress and anxiety. The technique can also help patients with COPD, who generally have weaker diaphragms, to take in more air with less effort. Most people are "shallow breathers," which means that they use the upper chest to breathe. This results in overuse of muscles in the neck and upper body, and underuse of the diaphragm. Shallow breathing is exacerbated during stressful situations or when people become anxious. Regular practice can make diaphragmatic breathing, a more energizing and restorative form of breathing, the default method. One way to get more practice is to take yoga classes, which almost always include a focus on breathing.
Most of us do not think about breathing much because we do it naturally. But learning better breathing techniques can improve your health in many ways.
Ong AML, Chua LTT, Khor CJL, Asokkumar R, Namasivayam V, Wang YT. "Diaphragmatic Breathing Reduces Belching and Proton Pump Inhibitor Refractory Gastroesophageal Reflux Symptoms." Clin Gastroentol Hepatol 2018 Mar;16(3):407-416.e2
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