title: A case study of chiropractic management of pregnancy-related heartburn with postulated fetal epigenome implications.
abstract: OBJECTIVE
  This case study reports on chiropractic care for pregnancy-related heartburn. The purpose of this article is to relate the benefit of chiropractic treatment for one individual, to contrast chiropractic management with the biomedical standard of care for pregnancy-related heartburn, and to point to potential epigenetic implications of the standard of care.
  
  
  METHODS
  A 32-year-old woman who was 24 weeks pregnant presented with persistent heartburn that she was treating with ranitidine (Zantac®) and calcium carbonate (Tums®) daily at the initiation of chiropractic care.
  
  
  RESULTS
  Findings of the initial examination were thoracic intersegmental dysfunction and pain upon palpation of the diaphragm, with hypertonicity noted. Therapy localization was positive for reflexes associated with the esophagus and lower esophageal sphincter, suggesting spasms. Emotional components also were identified in association with the symptoms by the use of a mind-body therapy called NeuroEmotional Technique. The patient was treated by adjusting the thoracic spine, manually releasing the diaphragm spasms, and releasing the esophageal spasm with an activator (a small hand-held instrument that creates a percussive force). The patient was symptom-free and did not use medication after the fifth treatment. She was followed throughout the remainder of her pregnancy and was asymptomatic and required no further treatment.
  
  
  CONCLUSIONS
  A larger study should investigate the effectiveness of chiropractic care for the treatment of pregnancy-related heartburn.
authors.affiliation: Fertile Ground Family Center, 2031 East Burnside Street, Portland, OR 97214, USA. imcarolinep@gmail.com
authors.forename: Caroline
authors.initials: C
authors.lastname: Peterson
mesh_terms: D000328:Adult; D002684:Chiropractic / Q000379:methods*; D003964:Diaphragm; D004644:Emotions; D044127:Epigenesis, Genetic; D004947:Esophagus; D005260:Female; D005333:Fetus; D006356:Heartburn / Q000150:complications / Q000235:genetics / Q000523:psychology / Q000628:therapy*; D006801:Humans; D026882:Manipulation, Chiropractic; D026441:Mind-Body Therapies; D011247:Pregnancy; D011248:Pregnancy Complications / Q000235:genetics / Q000523:psychology / Q000628:therapy*; D059039:Standard of Care; D013904:Thoracic Vertebrae