# Breathing exercises help strengthen LES



## Mr 100

I have mentioned on another thread [ http://www.ibsgroup.org/forums/topic/146501-gerd-causes-and-cures/ ] that I have experienced improvements in my heartburn from taking regular exercise on my bicycle. This article appears to confirm the idea of breathing as a way of increasing the strength of the LES.Breathing exercises may help soothe heartburnBy Amy NortonNEW YORK | Thu Dec 15, 2011 4:15pm EST NEW YORK (Reuters Health) - People with milder heartburn problems might find some relief from deep breathing exercises, a small clinical trial suggests.The study, of 19 adults with mild gastroesophageal reflux disease, or GERD, found that "belly breathing" exercises seemed to help reduce people's acid reflux, and eventually lessen their need for acid-suppressing medication.The findings, reported in the American Journal of Gastroenterology, hint that some people might be able to breathe their way to greater heartburn relief. But whether that's truly the case requires more research."I'm not sure what to think of the results because it's such a small study," said Dr. Neil Toribara, a gastroenterologist and professor of medicine at National Jewish Health in Denver.But if the breathing exercises are proven to help some people with GERD, it would be a welcome addition to the heartburn arsenal, said Toribara, who was not involved in the study."We wouldn't have to worry about side effects," he noted in an interview. And anything that can help people curb their reliance on medication -- which can have side effects -- "would be a good thing," Toribara said.GERD occurs when stomach acids move up into the esophagus, the passageway that connects the throat to the stomach. That leads to the familiar burning sensation in the chest known as heartburn.The problem is thought to rest in the ring of muscle at the bottom of the esophagus -- namely, that it opens when it shouldn't and allows stomach acid to back up.So it's possible that deep abdominal breathing might help with GERD by strengthening the surrounding muscles of the diaphragm, according to Dr. Karl Martin Hoffmann, the senior researcher on the study.To study the question, Hoffmann and his colleagues at Medical University Graz, in Austria, recruited 19 men and women with milder GERD -- milder in that they had no erosive damage to the esophagus.But their heartburn was bad enough that they were using acid-suppressing proton-pump inhibitors, which include medications like omeprazole (Prilosec), lansoprazole (Prevacid) and esomeprazole (Nexium).Hoffmann's team randomly assigned the patients into two groups. In one, people learned abdominal breathing exercises from a physical therapist, and were told to perform them daily for 30 minutes. The other group served as a "control" and did not learn the exercises.The researchers used a tiny catheter threaded through the nose and into the esophagus to take measurements of how much acid was getting into each participant's esophagus.After one month, the study found, people in the breathing-exercise group showed a drop, on average, in the amount of acid reaching the esophagus. They also reported improvements in their quality of life, which includes heartburn symptoms.After that first month, the rest of the study participants learned the breathing exercises. And nine months later, patients who'd stuck with the therapy were using medication less often -- cutting down to about one-quarter of their weekly dose at the study's start, the researchers found.One issue, though, was that only 11 out of the 19 patients actually stuck with the exercises. Some said they just preferred to take medication, some said they lacked the time for the exercises, and some admitted to being "too lazy."Both Hoffmann and Toribara said that breathing exercises are likely to have limited appeal."This method is definitely not 'the easy way out' for GERD patients if they want to try to control their symptoms," Hoffmann told Reuters Health in an email. "Swallowing anti-reflux pills is of course still very effective and much easier to do."Toribara said there are a number of non-drug ways to help soothe heartburn -- from diet changes, to quitting smoking, to losing excess pounds. But they all take effort."We know weight loss helps," Toribara noted. "But how many people actually do it?"So even if breathing exercises are proven useful in larger studies, Toribara said, it's not clear how popular the approach will become. "It's not something that would work immediately," he pointed out. "And we are a society that likes instantaneous results."In general, frequent heartburn (two or more times per week) is considered a sign of GERD. Many people have heartburn more sporadically: in the U.S., it's estimated that 60 million people have heartburn at least once a month, while 15 million have it daily.The cost of all those pills to treat it can add up. Prilosec and Prevacid cost about 50 cents per pill, while Nexium -- available only by prescription -- is more expensive, at more than $200 a month.SOURCE: bit.ly/uqq85Y American Journal of Gastroenterology, online December 6, 2011http://www.reuters.com/article/2011/12/15/us-breathing-exercises-idUSTRE7BE21N20111215


----------



## Mr 100

I will place some links and further info here as it comes to light.I have emailed prof. Karl Martin Hoffmann to enquire of the exact type of exercises he used in his 12 month clinical trial, and I will report any reply here.http://www.deepermeditation.net/oceanicmind/deep_belly_breathing_exercises_to_improve_lung_capacity.html audio contenthttp://www.cchs.net/health/health-info/docs/2400/2409.asp?index=9445 pictures and textre, abdominal breathing, this site seems to offer a good textual explanation, backed up by diagrams and a you tube video,http://www.drnickcampos.com/health-newsletter/AbdominalBreathing.html


----------



## Mr 100

I'm not surprised that some of the original members of the clinical trial failed to complete the whole year. I am finding it really difficult to find the time to spend half an hour a day doing abdominal breathing. I am finding it possible to do while, for example walking or when on the computer, so looking to make up the time this way.


----------



## Mr 100

...going slightly off topic here...I am sure that regular 'cardio' exercise is dramatically improving my health and both my IBS-D and reflux symptoms seem vastly improved. I suppose I can't be totally sure it's just the exercise, as I have also had dietry changes over the last six months.=========================================================================This report from Harvard caught my eye today. Researchers have identified a hormone, irisine."Spiegelman dubbed the hormone "irisin," after Iris, a Greek messenger goddess. He said the discovery is an important first step in understanding the biological mechanisms that translate physical exercise into beneficial changes throughout the body, both in healthy people and in preventing or treating disease."There has been a feeling in the field that exercise 'talks to' various tissues in the body," said Spiegelman, a professor of cell biology at Harvard Medical School. "But the question has been, how?" "So, this could confirm the idea of 'motion is lotion' Click the link for further info... http://www.dana-farber.org/Newsroom/News-Releases/Researchers-isolate-messenger-protein-linking-exercise-to-health-benefits.aspx


----------



## Mr 100

Picked this up on the newsfeed, look interesting...http://www.news-medical.net/news/20120710/Diaphragm-muscles-show-osteopathic-training-potential.aspxDiaphragm muscles show osteopathic training potentialPublished on July 10, 2012By Lucy PiperOsteopathic manipulative intervention to obtain functional equilibrium of the diaphragm increases lower esophageal sphincter (LES) pressure in patients with gastroesophageal reflux disease (GERD), researchers have found.This positive influence on the LES suggests that inspiratory muscles, including the diaphragm, could be trained in the same way that gait muscles are, thereby strengthening them and improving their performance, the team explains."Our results demonstrated that there was an increase of 9-27% of the LES pressure in patients who performed the osteopathic maneuvers, while in the group of patients who did not perform the maneuvers, a reduction of that pressure was observed," Tomas Navarro-Rodriguez (University of São Paulo School of Medicine, Brazil) and colleagues report.A total of 38 patients with GERD participated in the study, 22 of whom received osteopathic manipulation, involving a diaphragm-stretching technique commonly used by osteopathic physicians to obtain functional equilibrium of the muscles. The remaining participants received a sham technique.Manometry measures of the average respiratory pressure (ARP) and maximum expiratory pressure showed an increase following osteopathy, from 20.03 to 21.87 and 12.03 to 14.56, respectively.For patients receiving sham treatment, the readings for ARP and MEP fell, from 25.74 to 22.13 and 16.87 to 15.51, respectively.The average difference in ARP before versus after osteopathy reached statistical significance compared with before versus after the sham technique. Furthermore, the difference in ARP was of a high enough magnitude to be considered clinically relevant according to Cohen calculations."Our data are of extreme clinical importance and of high practical relevance because in the assessment by the LES esophageal manometry, we assessed the regions of the LES having greater pressure either by ARP or MEP, and not the average of all the sphincter assessment," note the researchers in Diseases of the Esophagus."Our findings appear important in connection with the potential clinical applications of the osteopathic treatment for GERD and consequently its benefit as co-adjuvant in the clinical or surgical treatment or maybe even in the future as a single therapy for some kinds of specific patients," they conclude."It is still not possible to say if these changes are durable, which requires continuation of the research in other centers and with a larger number of patients."


----------



## WeirdBodySyndrome

Mr 100 said:


> ...going slightly off topic here...I am sure that regular 'cardio' exercise is dramatically improving my health and both my IBS-D and reflux symptoms seem vastly improved. I suppose I can't be totally sure it's just the exercise, as I have also had dietry changes over the last six months.=========================================================================This report from Harvard caught my eye today. Researchers have identified a hormone, irisine."Spiegelman dubbed the hormone "irisin," after Iris, a Greek messenger goddess. He said the discovery is an important first step in understanding the biological mechanisms that translate physical exercise into beneficial changes throughout the body, both in healthy people and in preventing or treating disease."There has been a feeling in the field that exercise 'talks to' various tissues in the body," said Spiegelman, a professor of cell biology at Harvard Medical School. "But the question has been, how?" "So, this could confirm the idea of 'motion is lotion' Click the link for further info... http://www.dana-farb...h-benefits.aspx


Unless one is unable, one should try to exercise as much as possible. I am skeptic about this hormone that they speak of, regardless of the fact that the discovery comes from Harvard.
Why not just exercise a little if you can and let the hormones be generated naturally ?


----------

