Reflux? How can IMT help?

How can inspiratory muscle training help with symptoms of reflux?  It has to do with the mechanisms behind gastroesophageal reflux disease (or GERD). GERD is caused by the upward movement of gastric contents from the stomach into the esophagus.  This happens when the sphincter between the stomach and the esophagus (meant to be a one-way door) loses some of it's strength and function.  The result is that stomach contents end up flowing backwards into the esophagus (the pipe that food travels down into the stomach after we swallow).  Symptoms of GERD can be:

• heartburn - burning type pain in the chest area
• feeling of something in the throat
• throat clearing, coughing
• hoarse voice
• shortness of breath
• interrupted sleep

The diagram below shows how the the esophagus passes through the diaphragm and you can even see the muscle fibres of the diaphragm supporting the sphincter.  So it does makes sense that if the diaphragm isn't functioning well, then the sphincter function may also be reduced.  In fact, studies have indicated that individuals with GERD have reduced diaphragm function and altered breathing patterns.  

GERD can be difficult to treat and should include a an approach that includes lifestyle changes (diet, weight loss) and may include medications.  But more recent evidence has shown that strengthening the diaphragm can help.  A few studies have shown that participants with GERD who performed inspiratory muscle training for 4-8 weeks, had reduced symptoms of GERD.  Researchers theorize that IMT helps to improve the function of the lower esophageal sphincter.  For the more recent study abstract click here.  

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