The effect of breathing exercises on patients with GERD: a meta-analysis

Ann Palliat Med. 2020 Mar;9(2):405-413. doi: 10.21037/apm.2020.02.35. Epub 2020 Mar 17.


Background: Breathing exercises can improve the symptoms of patients with gastroesophageal reflux disease (GERD), but their specific effect and function are disputed. To evaluate and conduct a meta-analysis on the effect of breathing exercises on patients with GERD.

Methods: A literature search for randomized controlled trials (RCTs) and prospective studies on the effects of employing breathing exercises on patients with GERD was conducted of all major online English databases (PubMed, Embase, the Cochrane library, CENTRAL, Web of Science, AMED, and CINAHL). After the systematic review of all the studies according to inclusion and exclusion criteria, we analyzed the extracted data through meta-analysis by using RevMan 5.3 software.

Results: This thesis analyzes 7 studies (including three RCTs), which together involved 194 patients and 16 healthy volunteers. The primary outcomes of these studies included GERD symptoms, esophageal manometry, esophageal pH monitoring, laryngoscopic findings, and acid suppression usage. The results of meta-analysis indicate that breathing exercises can improve pressure generated by the lower oesophageal sphincter (LES), and a statistically significant difference was observed. The possible mechanism behind this is the enhancement of the anti-regurgitation barrier [especially crural diaphragm (CD) tension].

Conclusions: To some extent, breathing exercises can relieve the symptoms of patients with GERD.

Keywords: Breathing exercises; gastroesophageal reflux disease (GERD); meta-analysis; randomized controlled trial (RCT).

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Breathing Exercises / methods*
  • Exercise Therapy / methods*
  • Female
  • Gastroesophageal Reflux / therapy*
  • Humans
  • Male
  • Prospective Studies
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Respiratory Function Tests