title: Breathing training on lower esophageal sphincter as a complementary treatment of gastroesophageal reflux disease (GERD): a systematic review.
abstract: Gastroesophageal reflux disease (GERD) represents one of the most common gastrointestinal disorders, but is still a challenge to cure. Proton pump inhibitors (PPIs) are currently the GERD's standard treatment, although not successful in all patients; some concerns have been raised regarding their long term consumption. Recently, some studies showed the benefits of inspiratory muscle training in increasing the lower esophageal sphincter pressure in patients affected by GERD, thereby reducing their symptoms.
  
  
  
  Relevant published studies were searched in Pubmed, Google Scholar, Ovid or Medical Subject Headings using the following keywords: "GERD" and physiotherapy", "GERD" and "exercise", "GERD" and "breathing", "GERD and "training".
  
  
  
  At the end of our selection process, four publications have been included for systematic review. All of them were prospective controlled studies, mainly based on the training of the diaphragm muscle. GERD symptoms, pH-manometry values and PPIs usage were assessed.
  
  
  
  Among the non-surgical, non-pharmacological treatment modalities, the breathing training on diaphragm could play an important role in selected patients to manage the symptoms of GERD.
authors.affiliation: Unit of Otolaryngology, Campus Bio-Medico University, Rome, Italy. l.sabatino@unicampus.it.
authors.forename: M
authors.initials: M
authors.lastname: Casale
authors.forename: L
authors.initials: L
authors.lastname: Sabatino
authors.forename: A
authors.initials: A
authors.lastname: Moffa
authors.forename: F
authors.initials: F
authors.lastname: Capuano
authors.forename: V
authors.initials: V
authors.lastname: Luccarelli
authors.forename: M
authors.initials: M
authors.lastname: Vitali
authors.forename: M
authors.initials: M
authors.lastname: Ribolsi
authors.forename: M
authors.initials: M
authors.lastname: Cicala
authors.forename: F
authors.initials: F
authors.lastname: Salvinelli
mesh_terms: D049630:Esophageal Sphincter, Lower; D005764:Gastroesophageal Reflux / Q000628:therapy*; D006801:Humans; D008365:Manometry; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use
chemical_list: D054328:Proton Pump Inhibitors