GERD is a common condition in which the stomach contents persistently move back up into the esophagus and causes acid reflux on a consistent basis. The symptoms often include heartburn, vomiting, cough, burning sensation in chest or stomach ache.


Risk Factors:


  • Hiatal Hernia (upper part of the stomach has moved up to their chest)
  • Obesity (by putting more pressure on a person’s stomach, making lower esophagus open more often when they are not swallowing)
  • Gastropaesis (a person’s stomach takes s long time to empty, cause stomach making more acid)
  • Pregnancy
  • Certain medication
  • Lifestyle factors such as smoking (decreasing the amount of saliva production, causing stomach empty slowly), alcohol, caffeine, eating large meals late at night or eating before bed, irregular meal time
  • Stress
  • Foods
  • Foods that relax the lower esophageal sphincter eg: greasy foods, high-fat meats, mayonnaise, chocolate, caffeinated beverages and creamy sauces
  • Foods that stimulate acid production eg: alcohol, spicy foods, carbonated beverages and tomato juice
  • Genetic (inherited muscular or structural problems in the esophagus or stomach, pre-cancerous condition)

Importance of controlling the symptoms

If an individual experiencing the symptoms most of the days, the repeated exposure of the esophagus to stomach acids may cause damage to the tissue overtime. Although the irritation may be uncomfortable in the short-term but the long-term effects may include other complications including pre-cancerous changes (barrett’s esophagus), ulceration, esophagitis, esophageal stricture, respiratory problem such as asthma, chest congestion, wheezing and pneumonia.

There are four approaches for gastroesophageal reflux disease (GERD) treatment, including medication and surgery. Often, patients respond well to a combination of lifestyle changes and manual therapy such as visceral manipulation.



Visceral Manipulation (VM) Approach to manage gastrointestinal and acid reflux symptoms


Visceral Manipulation is about releasing fascial restrictions and re-establishing balanced of visceral mobility and organ motility and health. For examples, Gastrointestinal symptoms can improve as one treats the sphincters of the digestive tract. Resolving restrictions in motion of the sphincters can improve movement through the esophages, stomach and intestines and support overall digestion and elimination.


The therapist uses gentle pressure and stretching techniques to release any restrictions or imbalances that may be affecting the esophagus-diaphragm-stomach system. This can help restore the proper position and function of the stomach and esophagus, reducing the symptoms of a hiatal hernia and reduce future occurrences of reflux.


The esophagus, the sphincter and the diaphragm are constituted of myofascial tissues, and it is known that movement, pressure and stretching tend to improve the state of myofascial tissues in general terms. The manual technique can have a degree of influence in restoring normal muscle contraction/relaxation to the diaphragm, thus its influence on the gastroesophageal junction in the pathology of reflux – avoiding the use of medication or invasive medical procedures.


Prepared By

Kelly Tham

Your Physio Petaling Jaya


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