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Gastroesophageal Reflux Disease (GERD)

I was interested in sharing this very unusual case with other therapists because I was amazed at the results in treating this case of gastroesophageal reflux disease (GERD).


November 2, 2011
By Mike Dixon RMT

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I was interested in sharing this very unusual case with other therapists because I was amazed at the results in treating this case of gastroesophageal reflux disease (GERD).

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A specially designed massage table can increase or decrease curvatures of the spine.


In this article, I will outline the patient profile and condition followed by the treatment procedure and finally the clinical outcome. I will also include a discussion by Dave De Camillis, DC, showcasing his opinion regarding why this procedure worked.

Patient Profile

  • 48-year-old male suffering from GERD for the past 19 years.
  • Chief complaint is chest pain (indigestion) and a sore throat especially in the morning.
  • Works as a chef.
  • Previous treatments for managing the condition include medications, naturopathic medicine and chiropractic adjustments.
  • Posture was somewhat hyperkyphotic, and somewhat of a protruding abdomen.
  • Complicating factor: Hiatus hernia

What is Gastroesophageal Reflux Disease?
GERD is a common condition in which acid from the stomach flows back into the esophagus, causing discomfort and, in some instances, damage to the esophageal lining. The condition is thought to affect nearly half of all adults at least once a month.” (Definition from Taber’s Medical Dictionary, 19th Edition, page 932.)

Treatment procedure
As this patient appeared to have a slouched posture (hyperkyphosis) I decided that perhaps putting his spine into extension for five to 10 minutes would help in reducing stress to his thoracic spine, thereby reducing the stress to the esophagus. Before putting him into extension, I performed a deep paraspinals massage and joint play technique to the thoracic vertebra. I have a specially designed table that allows me to stabilize the spine with a strap and move the table into extension either to increase or decrease curvatures of the spine (see photo). In this case, I wanted to reduce the hyperkyphosis.

After approximately 10 minutes of extension, I positioned him supine and performed a diaphragmatic release. I also performed an abdominal lift procedure to try to reduce some of the downward drag on the abdominal contents and hiatus hernia. That concluded the first treatment.

Results
We will call this patient Jim. On his next visit, which was about two weeks later, “Jim” reported to me that all the symptoms had abated. No more sore throat! No more pain in the chest, no more heartburn. I was not only very happy for him but amazed! I certainly did not expect to hear this result after one session. Dr. David De Camillis, a local chiropractor whom I have studied under and from whom I learned the techniques above, discusses why this might be.

Comments from Dr. David De Camillis
I think it’s important to delve into the anatomy when discussing a particular kind of disorder. Why in the world would the procedure you used help this particular case? The answer is the sympathetic nervous system. I’m going to include the visceral afferents as part of the sympathetic system in this instance. Is the physiology of a sympathetic nerve that much different from any other nerves? Does neurogenesis take place with the sympathetics? Are afferent nerves in the discs any different from visceral afferents? I think the physiology of most nerves is the same. We think of nerves as being different because we name them that way. Following this logic, an expanded extracellular matrix will exist in affected visceral efferents and afferents. This edema is due to macromolecules being excreted by affected nerves and their associated connective tissue. (Interestingly, smooth muscle also secretes proteoglycans and the lower third of the esophagus contains smooth muscle.) In this particular case, new nerves in the patient’s mid-thoracic discs established reflex linkages to new nerves formed in the lower esophageal sphincter. Both these groups go to the same area of the spinal cord. By increasing the blood supply in the disc, the GERD abated. Why did these groups of nerves have this pathology? The answer is stress. Stress in the esophagus from stomach acids and stress in the discs due to poor posture, lack of exercise etc. It is the stress that causes the nerves and connective tissue to secrete the macromolecules. We can look at stress as being on a gradient from mild to severe. The more severe stress would cause tissue damage but proteoglycans would still be secreted.

Conclusion
If this technique has this potential to relieve symptoms of GERD, then I think it is our responsibility to attempt it on our patients, and, furthermore, “get the word out.” I am currently now treating other cases of GERD with similar results. Not every case is this amazing but I am finding a trend of improvement in the symptomology of this condition.


Mike Dixon has practised massage therapy for 25 years. He is an educator, a published author, and an international presenter in massage therapy continuing education  (Arthrokinetic Therapy). Mike graduated from the West Coast College of Massage Therapy in 1986 and has been teaching at the school since 1993. Mike was also the senior practical advisor for the college. His specialty is in orthopedics assessment and treatments. He also teaches at the Boucher Institute of Naturopathic Medicine. To contact him, please visit www.arthrokinetic.com.


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