Post by @mollypelletier.rd

My avoid list kept getting shorter and my reflux kept showing up anyway. What finally moved the needle was training the barrier itself. The lower esophageal sphincter (the valve at the top of your stomach) is wrapped by the crural diaphragm, a skeletal muscle that tightens around the valve on every inhale. Muscles respond to training. This one is no exception. The LES Lock: 1 to 5 minutes of diaphragmatic breathing with 360 ribcage expansion immediately after meals, up to 5x daily. Belly out on the inhale, ribs widen front, sides and back, exhale slower than you inhaled. Here is what I teach my clients, and what I still do myself. In a Mayo Clinic RCT, LES pressure during the inhale measured 42.2 mmHg vs 23.1 without it, and reflux events after eating fell from 2.60 to 0.36. Halland et al. 2021, Am J Gastroenterol, 23 GERD patients and 10 controls, PMID 33009052. In a separate RCT, four weeks of daily practice cut time with esophageal pH under 4 from 9.1% to 4.7%, with no change in controls, and the patients still training at 9 months were using less on-demand PPI. Eherer et al. 2012, Am J Gastroenterol, n=19, PMID 22146488. The second piece is your nervous system. The vagus nerve (your rest-and-digest pathway) helps regulate resting LES tone. Spend the day in fight-or-flight and digestion gets deprioritized, gastric emptying slows, and the diaphragm stays high and tight in the chest instead of moving low. A stressed system asks more of the barrier while giving it less to work with. Slow diaphragmatic breathing with a long exhale is itself a vagal signal, so the LES Lock does two jobs at once. Nervous System Snacks: 1 to 5 minute regulation breaks, 1 to 3 times a day, away from meals. Extended exhales or hand-on-belly breathing. My 3 breathing exercises for reflux are at the link in my bio. Follow for more and share this with someone whose avoid list keeps growing. Small hinges swing big doors. #AcidReflux #GERD #LES #DiaphragmaticBreathing #RefluxRelief