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Transforming GERD Treatment Through Breathing

photo of a woman practicing diaphragmatic breathing

Gastroesophageal reflux disease (GERD) is more than just a minor inconvenience; it’s a condition that can significantly disrupt your quality of life. While medications like proton pump inhibitors (PPIs) are often the go-to solutions, emerging research suggests that a dual approach involving diaphragmatic breathing and chiropractic care may offer natural and effective relief. In this article, we’ll explore this exciting avenue of treatment.

What is Diaphragmatic Breathing?

Diaphragmatic breathing, also known as “deep breathing,” involves the expansion of the abdomen rather than the chest when inhaling. This type of breathing engages your diaphragm, a large muscle located horizontally between your thoracic cavity (chest) and abdominal cavity. When you breathe in deeply, your diaphragm contracts and moves downward, making room for your lungs to expand and fill with air. As you exhale, the diaphragm relaxes, helping to push out air. This process aids not only in effective oxygenation but can also contribute to lower stress and increased relaxation.

The Impact of Poor Posture

It’s important to note that posture can significantly affect your ability to engage in diaphragmatic breathing. When you slump or slouch, you compress your abdomen and restrict the space your diaphragm has to move. This not only limits your ability to take deep, nourishing breaths but also forces your body to resort to ‘secondary’ breathing using muscles like the intercostals (muscles between your ribs) and trapezius (a major muscle in the back and neck). These secondary breathing muscles are not as efficient at promoting deep, full breaths, which can exacerbate symptoms like GERD. In essence, poor posture could be a hidden contributor to your discomfort.

In our Norwalk, CT practice, we often find that improving one’s posture through chiropractic adjustments can significantly enhance the effectiveness of diaphragmatic breathing, offering a dual approach to managing GERD symptoms.

The Science Behind Diaphragmatic Breathing for GERD

Recent research published in the American Journal of Gastroenterology and Clinical Gastroenterology and Hepatology suggests that diaphragmatic breathing can significantly reduce the symptoms of GERD. Studies showed that this breathing technique increased the pressure in the lower esophageal sphincter, thereby reducing the number of reflux events. Furthermore, it decreased the visual analogue scale score for belching by nearly 50%.

Why Chiropractic Care?

While diaphragmatic breathing can do wonders for GERD, its effectiveness may be influenced by your posture. That’s where chiropractic care comes in. By adjusting your spine and improving your posture, chiropractic care may make diaphragmatic breathing more effective and comfortable.

How Chiropractic Adjustments Facilitate Diaphragmatic Breathing

  1. Improved Posture: Straightening the back improves the capacity for deep breaths, allowing your diaphragm to contract and relax fully.
  2. Reduced Abdominal Pressure: Proper spinal alignment reduces the pressure exerted on your abdomen, which can reduce reflux episodes.

How to Perform the Combination Diaphragmatic-Square Breathing Technique

Instead of traditional diaphragmatic breathing, we recommend a specialized combo technique that merges the concept of square breathing with diaphragmatic breathing for enhanced results. Here’s how to do it:

  1. Position: Sit comfortably in a chair or lie down on a flat surface. Make sure your back is straight to facilitate better breathing.
  2. Hands Placement: Place one hand on your chest and another on your abdomen. This will help you become aware of your diaphragmatic movements.
  3. Square Breathing Base: In square breathing, you follow a 4-4-4-4 pattern—inhale for 4 seconds, hold for 4 seconds, exhale for 4 seconds, and hold for 4 seconds.
  4. Inhalation: Inhale slowly through your nose for a count of 4. As you inhale, make sure the hand on your abdomen rises more than the one on your chest. This means you are effectively engaging your diaphragm.
  5. Hold: Hold your breath for 4 seconds, keeping your focus on your abdomen, feeling it fully expanded.
  6. Exhalation: Exhale gently through your mouth for a count of 4. As you exhale, consciously suck in your abdomen to ensure complete diaphragmatic relaxation.
  7. Hold: Hold your breath again, this time for 4 seconds, while keeping your abdomen sucked in.
  8. Focus: Throughout this process, keep your mind focused on the present moment, or on the rhythmic flow of your breath.
  9. Frequency: Practice this combo diaphragmatic-square breathing technique for a cycle of 10 breaths, up three times a day.

Benefits of the Dual Approach

  1. Low-Cost: Neither diaphragmatic breathing nor chiropractic care require expensive medication.
  2. Low-Risk: These natural therapies are generally free from the side effects that come with long-term PPI use.
  3. Durability: Studies show the benefits of diaphragmatic breathing lasted up to 4 months post-intervention.


Although more extensive research is required, the current findings are promising. A dual approach involving diaphragmatic breathing and chiropractic care might just be the holistic solution for GERD that we’ve been waiting for. If you’re interested in adopting this two-pronged approach to managing your GERD symptoms, contact us or click below for a consultation today.