Exploring Osteopathic Visceral Treatment for Managing GERD

Osteopathic visceral manipulation is rooted in osteopathic medicine, which views the body as a unit where structure and function are interconnected. Visceral manipulation specifically targets the organs, including the stomach and esophagus, to improve function and alleviate discomfort. Traditionally, it has been used to address digestive issues, musculoskeletal pain, and other chronic conditions.

Ailments Traditionally Addressed:

• Digestive disorders
• Respiratory issues
• Musculoskeletal pain
• Chronic neck or back pain

How Osteopathic Visceral Treatment May Help with GERD

Benefit 1: Restoring LES Function

Osteopathic treatment targets the LES through manual manipulation, aiming to improve its function and reduce acid reflux.
Scientific Insight: Studies have shown that manipulation of the diaphragm and epigastric area can increase LES pressure, reducing the frequency of acid reflux events.

Benefit 2: Improving Cervical Mobility

Visceral treatment also addresses related musculoskeletal issues, such as cervical spine stiffness, which can exacerbate GERD.
Scientific Insight: Research shows that patients with GERD often experience neck tightness due to viscerosomatic reflexes. Osteopathic manipulation has been shown to increase cervical range of motion.

Benefit 3: Alleviating Pressure on the Diaphragm

By promoting diaphragmatic movement and relieving tension, osteopathic treatment may help prevent reflux by enhancing the body's natural mechanisms for keeping stomach acid in place.
Scientific Insight: Studies have found that diaphragmatic dysfunction is a contributor to GERD, and manual therapy can improve its function.

Benefit 4: Reducing Somatic Hypersensitivity

Patients with GERD often experience increased sensitivity in the neck and upper back due to nerve connections between the diaphragm and cervical spine. Osteopathic manipulation can reduce this sensitivity.
Scientific Insight: Manipulation of visceral organs has been shown to reduce pressure pain thresholds in the cervical spine, alleviating discomfort.

Research Supporting Osteopathic Treatment for GERD

Overview of Existing Research

Several studies have explored the effects of osteopathic visceral manipulation on GERD, focusing on symptom relief, LES pressure improvement, and neck pain reduction.

Specific Research Findings:

• Increased LES Pressure: Studies demonstrate a significant increase in LES pressure following osteopathic treatment.
• Symptom Relief: A trial showed that patients experienced a 37.8% reduction in GERD symptoms one week after treatment.
• Improved Cervical Mobility: Research highlights an increase in cervical range of motion in patients receiving osteopathic therapy for GERD.

How to Use Osteopathic Treatment for GERD

Preparing for Osteopathic Treatment

• Find a Certified Practitioner: Ensure your osteopath is licensed and experienced in visceral manipulation.
• Consultation: Your first session will likely involve an assessment of your GERD symptoms and overall health.
• Treatment Sessions: Typically, sessions last 30 minutes to an hour, and the number of sessions required will depend on individual needs.

Frequency and Dosage Recommendations

• Sessions per Week: Patients typically see results after two sessions, spaced a week apart.
• Maintenance Sessions: For ongoing relief, maintenance sessions every few months may be recommended.

Precautions

• Allergies: Ensure you are not allergic to any oils or products used during treatment.
• Interactions: Inform your practitioner of any medications you're taking.
• Pregnancy: Pregnant women should consult their doctor before beginning osteopathic treatment.

Combining Osteopathic Treatment with Other Remedies

Complementary Remedies:

• Chamomile Tea: Known for its anti-inflammatory properties.
• Aloe Vera Juice: Helps soothe the digestive tract.
• Probiotics: Improves gut health, which can reduce GERD symptoms.

Potential Synergies:

Combining osteopathic treatment with dietary changes and natural remedies like chamomile tea can enhance the overall effects, reducing inflammation and acid production.

Lifestyle Tips for Managing GERD

Dietary Changes

• Avoid trigger foods like spicy dishes, chocolate, and caffeine.
• Incorporate more alkaline foods like vegetables and whole grains.

Eating Habits

• Eat smaller meals more frequently.
• Avoid lying down immediately after eating.

Weight Management

Maintaining a healthy weight can reduce pressure on the LES, preventing acid reflux.

Sleep Adjustments

• Elevate the head of your bed by 6-8 inches.
• Sleep on your left side to reduce acid reflux at night.

References

Effects of Osteopathic Visceral Treatment in Patients with Gastroesophageal Reflux: A Randomized Controlled Trial

Osteopathic manual treatment has been recommended as a non-pharmacological therapy for Gastroesophageal Reflux Disease (GERD). However, to date, no study has supported the effectiveness of this intervention with respect to the symptoms of the disease. Our goal was to assess the effect of an osteopathic manual technique for the lower esophageal sphincter on GERD symptoms, cervical mobility and on the C4 spinous process pressure pain threshold (PPTs). Methods: A randomized, double-blind placebo-controlled trial was performed. Sixty subjects suffering from GERD participated in this study and were randomly assigned to either an experimental group (EG) (n = 29), who received the osteopathic technique for the lower esophageal sphincter, or to a control group (CG) (n = 31), who received a manual contact, which mimicked the osteopathic technique without exerting any therapeutic force. Randomization was computer-generated, with allocation concealed by sequentially numbered, opaque, sealed envelopes. The GerdQ questionnaire was used to assess symptom changes the week after intervention. Cervical Range of Motion (CROM) and algometer were used to evaluate cervical mobility and PPTs before and after both treatments. Before–after between groups comparison (t-test) was used for statistical analysis of the outcome, with two measurement points (GerdQ), while repeated-measures ANOVA was used for those outcomes with four measurement points (CROM and PPT). Results: The application of the osteopathic manual treatment in subjects with GERD produced a significant improvement in symptoms one week after the intervention (p = 0.005) with a between-groups difference of 1.49 points in GerdQ score (95% CI: 0.47–2.49). PPT C4 improved in the EG after the treatment (p = 0.034; η2 = 0.048) (between-groups difference 8.78 Newton/cm2; 95% CI: 0.48–17.09). CROM also increased in the EG compared to the CG (p < 0.001; η2 = 0.108) (between-groups difference 33.89 degrees; 95% CI: 15.17–52.61). Conclusions: The manual osteopathic technique produces an improvement in GERD symptoms one week after treatment, cervical mobility, and PPTs. This may mean that osteopathic treatment is useful for improving symptoms of GERD.

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