Neurogastroenterology and motility · 2025
Effect of Diaphragmatic Breathing Training on the Esophagogastric Junction and Esophageal Motility in Patients With Reflux Symptoms.
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Zdrhova Lucie, Bitnar Petr, Friedl Lukas, Mares Jan, Madle Katerina, Balihar Karel, Kolar Pavel, Kozeluhova Jana, Fox Mark, Martinek Jan
Аннотация
BACKGROUND: Diaphragmatic breathing training (DBT) improves symptoms in patients with gastroesophageal reflux disease; however, the effect of DBT on the anti-reflux barrier and esophageal motility is unclear. This study aimed to evaluate the changes in specific parameters of EGJ function and esophageal motility before and after DBT using high-resolution manometry (HRM) in patients with reflux symptoms.
METHODS: Prospectively collected data from adult patients with persistent reflux symptoms who underwent initial and follow-up HRM after at least 3 months of DBT were analyzed. Esophagogastric junction (EGJ) function was assessed using basal lower esophageal sphincter (LES) pressure (LESP), the EGJ contractile integral (EGJ-CI), and integrated relaxation pressure (IRP). Esophageal motility was assessed using the distal contractile integral (DCI) and percentage of ineffective esophageal motility (IEM).
KEY RESULTS: Data from 53 patients with a median age of 45 years (range 25-77) were analyzed. LES pressure increased after DBT (mean LES pressure 25.6 [SE 1.3] vs. 29.1 [SE 1.4] mmHg after DBT; p = 0.02). This effect was also observed in patients with an initially hypotensive LES, but no effect was found on the size of hiatus hernia. There was a trend to increased EGJ-CI (mean EGJ-CI 52.8 [SE 3.7] vs. 59.9 [SE 4.3] mmHg·cm after DBT, p = 0.07). Esophageal contractility improved (mean DCI 1046.6 [SE 112] vs. 1264.1 [SE 137] mmHg·s·cm after DBT; p < 0.01) with the prevalence of IEM reduced from 38.0% [SE 5] to 29.2% [SE 4] after DBT; p = 0.03.
CONCLUSION AND INFERENCES: Diaphragmatic breathing training increased LES pressure and esophageal peristaltic vigor in patients with reflux symptoms.
METHODS: Prospectively collected data from adult patients with persistent reflux symptoms who underwent initial and follow-up HRM after at least 3 months of DBT were analyzed. Esophagogastric junction (EGJ) function was assessed using basal lower esophageal sphincter (LES) pressure (LESP), the EGJ contractile integral (EGJ-CI), and integrated relaxation pressure (IRP). Esophageal motility was assessed using the distal contractile integral (DCI) and percentage of ineffective esophageal motility (IEM).
KEY RESULTS: Data from 53 patients with a median age of 45 years (range 25-77) were analyzed. LES pressure increased after DBT (mean LES pressure 25.6 [SE 1.3] vs. 29.1 [SE 1.4] mmHg after DBT; p = 0.02). This effect was also observed in patients with an initially hypotensive LES, but no effect was found on the size of hiatus hernia. There was a trend to increased EGJ-CI (mean EGJ-CI 52.8 [SE 3.7] vs. 59.9 [SE 4.3] mmHg·cm after DBT, p = 0.07). Esophageal contractility improved (mean DCI 1046.6 [SE 112] vs. 1264.1 [SE 137] mmHg·s·cm after DBT; p < 0.01) with the prevalence of IEM reduced from 38.0% [SE 5] to 29.2% [SE 4] after DBT; p = 0.03.
CONCLUSION AND INFERENCES: Diaphragmatic breathing training increased LES pressure and esophageal peristaltic vigor in patients with reflux symptoms.