Learn this simple action to ease acid reflux and heartburn easily

Only for medical professionals to read for reference.
Simple 4 steps, easy to master abdominal breathing! During the festive season, friends and relatives gather, delicious food, and enjoy the wine.

I don’t want to have gastroesophageal reflux disease (GERD) frequently after drinking, eating, and drinking, and suffering from acid reflux and heartburn.

GERD is a common disease of the digestive system, which refers to the reflux of gastroduodenal contents into the esophagus causing symptoms such as acid reflux and heartburn.

The treatment of GERD not only requires standardized medication, but lifestyle intervention is also critical.

In addition to the well-known interventions such as smoking cessation, weight loss, and sleeping posture with head high and low feet, recent studies have pointed us to a simpler and more effective way-abdominal breathing (DB) [1].

A number of studies have confirmed that abdominal breathing can effectively improve the symptoms of GERD ■ Abdominal breathing can significantly reduce acid exposure and proton pump inhibitor (PPI) dosage, improve the quality of life of patients, and the effect will last for a long time.
An article published in American Journal of Gastroenterology[2] In the randomized controlled trial, 19 patients with GERD (no mucosal damage or mucosal damage healed) were included, and they were randomly divided into an abdominal breathing group and a control group.
Patients in the abdominal breathing group received 4 weeks of abdominal breathing training + press PPI treatment is required.
Patients in the control group only received on-demand PPI treatment for 4 weeks.
After 4 weeks, both groups received abdominal breathing exercises and followed up again 9 months later.

The results showed that the pH<4 time of patients in the abdominal breathing group at 4 weeks was significantly shorter than that before abdominal breathing training, and the quality of life was significantly improved, while the control group had no such change.

The follow-up at September showed that the quality of life of patients who insisted on abdominal breathing improved significantly, and the amount of PPI was significantly reduced, while the patients who did not continue abdominal breathing did not experience this change.

■ Abdominal breathing is still effective for refractory GERD.
A prospective study published in Clinical Gastroenterology and Hepatology [3] included 36 refractory GERD patients with a visual analogue scale (VAS) ≥ 6 points for belching.
For the abdominal breathing treatment group (receiving 4 weeks of abdominal breathing training) and the waiting group (waiting for 4 weeks to perform abdominal breathing training), questionnaire assessments were carried out at the beginning of the trial, 4 weeks and 4 months of the trial.

The main outcome of the study was a reduction of ≥50% in VAS, and the secondary outcome was GERD symptoms and quality of life scores.

The results showed that at 4 weeks of the trial, 60% of the patients in the abdominal breathing treatment group reached the main outcome indicators, which was significantly higher than the waiting group (no patients reached the standard), and abdominal breathing treatment can significantly improve the symptoms of GERD and improve the quality of life of patients; These benefits persisted after 4 months of adherence to abdominal breathing therapy.

■ Abdominal breathing can effectively improve the gastrointestinal symptoms of patients with GERD and relieve their anxiety, depression and other emotions.
A domestic study [4] included 86 patients with GERD and divided them into an observation group and a control group with 43 cases each according to a random number table.
The group received routine nursing, and the observation group received abdominal breathing exercises on the basis of routine nursing.
The gastrointestinal symptoms and psychological symptoms of the two groups were compared before and 8 weeks after the intervention.

The results showed that the total score of gastrointestinal symptoms, anxiety self-rating scale, and depression self-rating scale scores of the observation group after 8 weeks of intervention were (8.
21±3.
89), (44.
03±4.
56), and (33.
26±5.
97) points, respectively , The control group were (11.
69±4.
77) points, (46.
26±4.
30) points, (36.
24±7.
02) points, the difference was statistically significant (P<0.
05).

How to relieve acid reflux, heartburn, abdominal breathing? Abdominal breathing may improve the symptoms of GERD by increasing the pressure of the lower esophageal sphincter (LES).

Normal LES pressure is one of the important barriers against reflux.

A recent randomized controlled trial from the United States explored its possible mechanism while evaluating the effect of abdominal breathing.
The study was published in the American Journal of Gastroenterology [5]. The study included 23 GERD patients confirmed by pH monitoring and 10 healthy controls, who were randomly divided into abdominal breathing group and control group.

The results show that abdominal breathing training after meals can significantly reduce the number of acid reflux after meals.

All patients were subjected to a stress test, and the data showed that the LES increased significantly during the inhalation phase of abdominal breathing.

Simple 4 steps, easy to master abdominal breathing [4] Abdominal breathing is a way to complete breathing by increasing diaphragm activity and reducing chest movement.

Source: 10.
20319 / pijss.
2018.
43.
196207 The exercise positions include standing, sitting, and supine positions.
You can choose any position according to your own habits.

Standing position: Stand naturally, raise your head and chest, keep your upper body upright, relax your shoulders, spread your feet to the same width as your hips, so that your body weight is evenly distributed on your feet.

Sitting position: Sit naturally on a stool, keep your upper body upright, and relax your shoulders.
Separate your knees to the same width as your hips.
Bend your legs and sag naturally.
Keep your calves perpendicular to the ground.
Place your feet flat on the ground and your hands on your thighs.
.

Supine position: Lie flat on a soft cushion or bed, relax your upper arms and straighten them naturally.

Recommended exercise method: When exercising, place your hands under the umbilicus and gently press your abdomen.
Inhale through the nasal cavity.
At the end of the inhalation, the abdomen will be raised and your hands will be raised.
State➡️Then exhale slowly through the mouth, relax the muscles of the whole body, and gently press down with both hands as the abdomen is sunken.

Control the ratio of inhalation-expiration time to 1:2～1:3.
Every 10 breaths is a group.
There are 3 to 4 normal breaths between the two groups.
Exercise for 15 minutes a day, on an empty stomach or 2 hours after a meal, and exercise continuously for 8 weeks.
.

Note: When breathing exercises, ensure that the surrounding environment is quiet, free from external influences, and in a calm and relaxed state, with a stable breathing rhythm; it is best to fix each breathing exercise at the same time period, try to choose an empty stomach or 2 hours after a meal; if If you have dizziness, acid reflux and other uncomfortable symptoms, stop exercising in time, and decide whether to continue exercising on the same day according to your personal circumstances.

To prevent GERD, you can also do this [6] 1.
Control weight and reduce waist circumference. Overweight or obese patients with gastroesophageal reflux should develop a healthy weight loss plan, and control their weight within a reasonable range through diet and exercise.

2.
Avoid excessive consumption of high-fat and high-protein foods, and adjust the intake of chocolate, tea, coffee and other foods according to your own conditions to avoid inducing reflux.

3.
Avoid eating too much at one time, especially for dinner.
You can eat a small amount of meals.

4.
Quit smoking and drinking.

5.
For GERD patients with symptoms at night, you can sleep with the head of the bed raised and the left side lying.

Avoid eating 2-3 hours before bedtime.

6.
For people with anxiety, depression, and chronic stress, intervention and correction should be actively carried out. Finally, ensuring a good and regular work and rest, a moderate diet, and a relaxed mood are the keys to preventing all diseases! References: [1] Talley NJ, Zand Irani M.
Optimal management of severe symptomatic gastroesophageal reflux disease.
J Intern Med.
2021 Feb;289(2):162-178.
[2]Eherer AJ, Netolitzky F, Högenauer C, Puschnig G, Hinterleitner TA, Scheidl S, Kraxner W, Krejs GJ, Hoffmann KM.
Positive effect of abdominal breathing exercise on gastroesophageal reflux disease: a randomized, controlled study.
Am J Gastroenterol.
2012 Mar;107(3):372-8 .
[3]Ong AM, Chua LT, Khor CJ, Asokkumar R, S/O Namasivayam V, Wang YT.
Diaphragmatic Breathing Reduces Belching and Proton Pump Inhibitor Refractory Gastroesophageal Reflux Symptoms.
Clin Gastroenterol Hepatol.
2018 Mar;16(3): 407-416.
e2.
[4]Fang Ying.
Observation on the effect of abdominal breathing exercises applied to patients with gastroesophageal reflux disease.
Nursing and Rehabilitation, 2020, 8, 19(8).
[5] Halland M, Bharucha AE, Crowell MD, Ravi K, Katzka DA.