Usually reflux of the esophagus, or gastroesophageal reflux, is detected late, when inflammation of the inner wall of the esophagus is already developing -. This is due to the fact that before the appearance of the inflammatory process, which can be seen with fibrogastroduodenoscopy, it is quite difficult to detect reflux. Available methods: X-ray diagnostics with contrast agents, chromendoscopy, histological examination are not accurate enough at an early stage of the disease. Of course, there are reliable diagnostic methods: many hours of measuring the acidity of gastric juice, measuring pressure, esophageal impendansometry - but not everyone has the opportunity to carry them out, and not every patient agrees to many hours of research using a nasal probe.

Symptoms

The main symptoms of esophageal reflux are:

Heartburn;
- belching with air or;
- burning sensation in the chest;
- a feeling of discomfort in the upper abdomen.

When these symptoms appear on FGDS, it is already possible to detect areas of inflammation and ulcers.

When these symptoms appear on FGDS, it is already possible to detect areas of inflammation, erosion and ulcers.

Since the disease itself does not go away, it must be done. But often patients are afraid to take medicines, because it is the esophagus and stomach that are a sore subject for them. And they're trying to limit the chemical exposure to them. In this case, they are interested in treatment with exercise therapy, as well as folk methods treatment with wormwood, dandelion and celery. So can reflux be cured with exercise?

Reflux Exercises

Reflux itself cannot be cured by exercise alone. This is because the causes of reflux are completely different. These include:

Anatomical features of the upper part of the stomach;
- hernia of the esophageal opening of the diaphragm;
- increased acidity of gastric juice;
- weakness of the lower esophageal sphincter;
- neuroses;
- stress;
- Diet disorders (fatty, spicy foods, foods that promote gas formation);
- gastroduodenal reflux, when bile and pepsin, which is produced by the pancreas, enter the stomach and then into the esophagus;
- other diseases of the gastrointestinal tract.

It is impossible to eliminate these causes by exercises. Therefore, drug treatment is often aimed at treating the disease that provoked reflux. And if neurosis and stress are cured by conservative methods, then a hernia can only be cured surgically.

But this does not mean that exercise therapy is not needed. Therapeutic exercises help to strengthen the diaphragm, which has a beneficial effect on the lower esophageal sphincter and helps to retain gastric contents in the stomach.

Since the exercises are designed to reduce the frequency of reflux, you need to perform them correctly and make sure that heartburn, belching, or noticeable discomfort do not appear in the process.

Since the exercises are designed to reduce the frequency of reflux, you need to perform them correctly and make sure that heartburn, belching, or noticeable discomfort do not appear in the process.

The main thing in exercises is correct breathing, it is it that helps to strengthen the diaphragm. Therefore, you need to learn chest breathing, in which the diaphragm actively participates. In the first couple of weeks, breathing exercises are performed lying down, for 5-7 minutes, as many approaches as possible. Then exercises for isometric tension are added to them.

Exercises should be selected by a specialist in physical therapy. But in no case should they pass with an increase in intra-abdominal pressure. Therefore, if you feel that during exercise therapy your abdominal muscles are very tense, then this exercise is not for you.

Reflux cannot be cured by exercise alone. But exercise therapy is a great help that will help strengthen the diaphragm and reduce the frequency of reflux.

For the treatment of gastroesophageal reflux, there are many means to get rid of annoying unpleasant symptoms forever or at least for the next decades. For prevention, it is not necessary to use drugs, it is enough to periodically observe a diet and change something in your lifestyle.

Another preventive measure is breathing exercises for GERD. This is another attempt to protect against the disease, which in the general arsenal of a suffering person can be quite an effective method.

Gymnastics is not a cure

Before moving completely to this type of assistance, everyone should understand for himself some important points:

• gymnastics does not relieve heartburn, this method only helps to speed up the recovery process or reduce the periods and number of exacerbations;
• there is no ideally designed exercise scheme, everyone can choose for themselves those that will subsequently provide him with real help;
• gymnastics for GERD is not the main method of treatment, without the combined use of drugs and if the diet is not followed, exercises will not be effective;
• there is no 100% guarantee that classes will positively affect the process of getting rid of reflux disease, do not harbor illusions about a happy full recovery.

On this moment there is no complex selected for each disease of the digestive system. This is most often general exercises, which will not save in an emergency, but can alleviate the course of the disease.

Tasks with which therapeutic gymnastics copes

Like any physiotherapy method (gymnastics can rather be attributed to exercise therapy - physiotherapy exercises), it should be selected individually, taking into account the load tolerance and the course of the disease process. Whereby physiotherapy works positively:

• the body's defenses are stimulated, there is a general strengthening effect on a person;
• develops well with any exercise muscular system and vessels, which provides more enhanced nutrition of surrounding tissues and promotes the regeneration (healing) of damaged layers;
• if gymnastics with reflux esophagitis is well chosen, you can strengthen the lower esophageal sphincter (a round muscle between the esophagus and stomach), the weakness of which leads to food being thrown back;
• sometimes exercise helps reduce the number of reflux at night, improve the absorption of drugs, reduce their intolerance.

But, as already mentioned, this is not a magic pill for all the symptoms associated with GERD.

Breathing exercises

The basis of such treatment is proper breathing, which can be both an independent exercise and, together with other types of load, an attempt to train. internal organs.

1. To start, you need to accept comfortable posture Better standing or sitting. Then you need to take a deep breath and exhale slowly. When exhaling, try to use the muscles of the abdominal cavity (“we exhale with the help of the stomach”), this is how the respiratory muscles, which are closer to the stomach, work better. This exercise must be repeated 3-4 times.
2. Respiratory gymnastics also applies to next exercise: a calm deep breath and a quick exhalation of the "belly". The number of exercises increases to 10.
3. Then you can take a deep breath, hold your breath and at the same time try to "squeeze" the abdominal muscles as much as possible, pause for 5 seconds and exhale calmly. Over time, it is worth increasing the pauses to 10-15 seconds.
4. Another exercise option is a calm breath and a forced gradual exhalation, as if you have to exhale several times.

Gymnastics should be accompanied by pauses for rest, frequent and deep breaths and exhalations can lead to dizziness, and in some cases to loss of consciousness. Therefore, in such treatment, speed is not the main thing.

Important Prohibitions and Cautions

As with any sport, such gymnastics has its own requirements:

• during a severe course of GERD, gymnastics should be postponed until the pronounced symptoms subside;
• do not carry out this treatment after a full meal, a light snack or even a sip of water, this will only help to weaken the esophageal sphincter;
• All movements must be carried out in calm state, you can not perform them lying down or half-sitting.

Gastroesophageal reflux disease can worsen 2-3 times a year, so gymnastics should be a way to prevent it. It is better to conduct classes at least twice a week.

Do not try to develop a set of exercises on your own, it is better to consult a gymnastics instructor. Perfect option- when a specialist works in a medical institution and is familiar with the specifics of occupations with diseases.

Don't just rely on breathing exercises, it does not exempt from other activities. It is better to combine them with swimming, walking, light running.

Exercises are carried out without load, the hands should be free, not the muscles of the limbs or the back are trained, but the internal organs are stimulated.

How to diversify the methods of prevention and treatment with reflux esophagitis? Can be added to complex therapeutic gymnastics. It will not harm the course of the underlying disease, but will only help and alleviate many of its manifestations.

In the process of treating many diseases of the gastrointestinal tract, patients are often interested in whether they are shown sports, and if so, how exactly and with what intensity. Exercise is an important part of therapy for reflux esophagitis.

Of course, by themselves they will not cure a diseased organ, but in tandem with a therapeutic diet and medical support, they can greatly accelerate recovery and contribute to the overall strengthening of the body.

The nuances of training for GERD

Gastroesophageal reflux disease forces you to draw up a special training plan that takes into account the severity of the disease and the general physical training patient.

A scientifically proven fact is that people who exercise regularly suffer much less from the specific symptoms of reflux disease than physically inactive people with a sedentary lifestyle, and even more so with excess weight.

Excess weight greatly increases the chances of becoming the owner of GERD. People with a body mass index over 30 are more than 2 times more likely to become patients of a gastroenterologist than people with normal BMI within 18.5–25.

Moderate sports, especially regular therapeutic and preventive gymnastics, greatly facilitate the course of the disease, alleviate the symptoms, and sometimes completely reduce them to nothing.

However, the patient should not forget that overload he is contraindicated. In addition, in order not to aggravate your condition, you need to follow the recommendations of the doctor and trainer, and also do not forget about the following rules:

• Digestion takes time. By itself, the stomach filled with food is a load on the sphincter of the esophagus, and when shaking and physical stress are added to this, deterioration is inevitable. To prevent this, you need to train only on an empty stomach.
• When compiling a diet, you need to focus on your training schedule. Certain foods, especially fatty and legumes (by the way, a diet for reflux esophagitis prohibits such food) are digested for an extremely long time. If training should take place 2-3 hours after a meal, preference should be given to easily digestible carbohydrate foods, with a minimum content of fats and proteins. Before training, you need to exclude the consumption of foods that provoke heartburn and belching.
• Avoid overly intense exercise such as fast run, crossfit, aerobics. With such a load, the contents of the stomach are shaken, resulting in discomfort. It is worth giving preference to exercises that keep the body in a “flat” position: yoga, moderate jogging, skating, cycling (you can use an exercise bike or a stepper).
• No need to get involved in exercises in the prone position (bench press, Pilates), which provokes the reflux of stomach contents into the esophagus.
• Throughout the training session, it is worth monitoring the balance of fluid in the body. In addition to quenching thirst, water stimulates digestion and stabilizes the functional state of all organs.

Benefits of Exercise in GERD

Among the advantages of exercise therapy for reflux esophagitis include:

• strengthening the lower esophageal sphincter;
• reducing the intensity of reflux of stomach contents into the esophagus and mitigating the course of nocturnal refluxes;
• increasing the immune defense of the body;
• stimulation of metabolic processes.

Breathing exercises for GERD

The key to effective training for reflux esophagitis is proper, even breathing. Before you give yourself an active load, you need to take a comfortable position (most importantly, not lying down). After that, the patient will have to perform the following tasks in turn:

• Inhale deeply and release the air slowly. Repeat the exercise at least 5 times. When exhaling, it is necessary to involve the abdominal organs in the work as much as possible, strongly straining and “blowing out” the stomach.
• Slowly inhale the air and release it in a few short exhalations.
• The next task: take a slow, deep breath and a sharp, rapid exhalation, actively engaging the peritoneum. Repeat the exercise 8-12 times.
• Inhale deeply, hold your breath for 5-7 seconds. Slowly release the air, tensing the abdominal muscles as much as possible. Make several approaches, gradually increasing the period of holding your breath to 17 seconds.
• Don't forget to take proper rest between sets. Such breathing exercises can cause dizziness, and an unprepared, physically weak person may even faint.

Breathing exercises with reflux esophagitis reduce the pain of symptoms, reduce intra-abdominal pressure and stimulate the stomach. Any exercise should be done with maximum strain. abdominal muscles and as if exhaling belly.

Prohibited exercises for GERD:

• any exercises for the press, especially those associated with lifting the legs in a prone position;
• forward torso and all similar exercises;
• lifting sports equipment weighing over 10-12 kilograms.

The GERD Therapeutic Training Plan excludes exercise in horizontal position, as they intensify the reflux of the contents of the stomach into the esophagus and increase discomfort: heartburn, burning, pain.

Any exercise is best performed in a sitting or standing position. Moderate-intensity exercise is excellent for stimulating digestive function, and sufficient water intake further contributes to this.

In addition to medium-intensity aerobics, with reflux esophagitis, you can do exercises to strengthen the legs, arms and core muscles:

• swing legs and arms;
• any training combinations in the knee-elbow position;
• a variety of dumbbell lifts (total weight should not exceed 15 kilograms) and a bodybar in a sitting and standing position.

By following all of the above recommendations, with patience and patience, and with the support of a trainer specializing in exercise therapy, you can not only reduce the unpleasant symptoms of GERD, but also strengthen and improve the body. In tandem with proper nutrition and medical support (exclusively on the recommendation of the attending physician), recovery is progressing by leaps and bounds.

You may also be interested

Insufficiency of the cardia of the esophagus is a pathological condition consisting in incomplete closure of the valve that separates the interior of the gastric region from the esophagus. The main function of this sphincter is to protect the esophagus from not only gastric juice, but also enzymes that take part in the digestion process. That is why the problem of insufficiency of the lower esophageal sphincter, as well as the upper one, must be approached extremely carefully. Special attention is paid to exercises that help restore its function.

Causes and symptoms of cardia insufficiency

Before understanding the features of treatment, I would like to pay special attention to what are the causes and symptoms of insufficiency of the esophageal cardia. The main factor is poor nutrition, and one should not forget about the use of carbonated drinks in significant quantities, strong tea, alcoholic beverages and coffee. Other no less significant provoking factors should be considered the maintenance of a passive lifestyle (especially in physical plane), excessive body weight, other diseases of the stomach - gastritis, peptic ulcer. The next reason for the need for exercise in case of insufficiency of the cardia of the esophagus, experts call increased pressure inside the peritoneum.

Much more attention should be paid to the symptoms of the presented pathological condition, because this list contains constantly recurring heartburn.

Its characteristic feature is the formation, regardless of the sessions of eating. Other symptoms of the disease include:

• burning sensation behind the sternum and a constant feeling of fullness in the stomach;
• periodic belching of air;
• rumbling and gurgling in the intestinal area;
• pain in the abdomen, having a "vague" character. They do not have any clear localization;
• aggravation of appetite and even apathy.

Additional symptoms indicating that it is necessary to start treatment are a decrease in the ability to work and general rapid fatigue. The tasks of exercise therapy, the features of its implementation and breathing exercises deserve special attention.

The main tasks of exercise therapy

The leading tasks of exercise therapy, experts call, first of all, the stabilization of the motor function of not only the stomach, but also the intestines. In addition, it is in this way that the fight against progressive flatulence is ensured. The next task of exercise therapy for esophageal achalasia is to increase the contractility of the lower esophageal sphincter. As you know, the legs of the diaphragm directly take part in the formation of the latter, which also need to be trained.

The next task is to increase the strength and strength of the diaphragm. This is what will allow a person to count on the correct operation of the esophagus, and hence the entire digestive system. However, in order to achieve the presented goals, it is strongly recommended not to forget about all the features of the implementation of exercise therapy.

Features of exercise therapy

Exercise therapy classes are carried out no earlier than 120-150 minutes after eating. At the beginning of the recovery course, the main positions should be considered such as lying on your back and right side. In this case, an inclined plane with a head end raised by 15-20 cm is used. Speaking about the features of such a training, I would like to note that:

1. considerable attention is paid to the so-called abdominal breathing;
2. the criterion for the correct implementation of all exercises without exception should be considered the absence during training of symptoms such as heartburn or, for example, belching;
3. to the complex exercise systematically include such elements as leg movements, turns of the torso in the initial position lying on the back;
4. later, the right and left sides, as well as the stomach and knees, are connected to the exercises presented. Some exercises can be done while standing.

Noting the features of the exercise, I would like to note that they are carried out starting from the starting position on the knees and exclusively standing. To do this, a person will need to carry out extension, torso inclinations in different sides as well as twists and squats. In the last stages, when the recovery effect turned out to be significant, the introduction of walking and jogging is acceptable.

For a sufficiently long period of time, flexion of the body and all those movements that increase the pressure indicators directly under the diaphragm are not recommended.

The presented rule also affects training on special simulators. I would like to draw attention to the fact that after the elements, implying isometric muscle tension, their relaxation must be ensured without fail.

According to experts, exercise therapy is the most effective for various functional disorders, as well as the so-called sliding hernia in the esophagus. In order to achieve success in the treatment process, classes are recommended to be carried out regularly. Speaking of this, pay attention to the frequency of at least two to three months, namely from one to two times a day. Wherein prerequisite is an increase in load. Given the huge variety of exercises and elements, it is advisable to discuss specific algorithms for their implementation with your doctor.

Briefly about the massage

In order to ensure the fight not only with flatulence, but also with constipation, an independent massage is strongly recommended. Speaking of this, they pay attention to the massage of the abdominal region, which is carried out with the help of a hockey or tennis ball. Also useful is massage of the lumbosacral region and peritoneum, unhurried walking and swimming (at a slow pace, for your own pleasure).

Other useful elements include riding a bicycle with an upright position of the torso, as well as all kinds of minimally traumatic games. In this case, it is desirable to avoid tilting the body forward. In order for the cardiospasm of the esophagus to be excluded, one should not forget about the benefits of all kinds of respiratory elements.

Breathing exercises

The situation is more difficult with the esophagus, it costs a lot of effort to stimulate it. But a little help can be provided by ordinary breathing exercises. TO general recommendations include the following items:

• all elements can be carried out exclusively on an empty stomach, at least because active exercise on a “full” stomach will inevitably lead to aggravation of the condition of the lower esophageal sphincter;
• practically the only organ in the sternum that can be controlled is the lungs;
• in this regard, it is advisable to start the usual and completely natural respiratory movements. For example, alternately inhale and exhale;
• there is one minor feature - the elements carry out not only chest, but also abdominal breathing. Speaking of this, they mean such a process in which, within the framework of inhalation and exhalation, not only rib cage but also the shoulders.

In addition, in the latter process, the participation of muscles is an obligatory element. abdominals. Only in this way it will be possible to achieve a significant increase in the tone of the sphincter of the esophageal opening of the diaphragm. A variety of internal organs take part in the process of training, namely the digestive and cardiovascular systems, the respiratory departments and the muscles and vessels located nearby.

In the last stages of exacerbation general condition sphincter exercises will not prove effective. While at the initial stages of loss of the ability to optimal contractions by the area of ​​the cardia of the esophagus precisely due to breathing exercises everything can be restored.

It will be more than enough to make such active respiratory movements every day, namely for 10-15 minutes. Experts recommend not to be lazy and carry out at least two or three approaches three times a day - this is the minimum amount. It is desirable that there be about five such repetitions during the day. This will also allow you to get rid of such an urgent problem as esophageal achalasia. In order to consolidate the effect obtained, it is recommended to resort in addition to physiotherapy.

Features of physiotherapy

Such physiotherapeutic techniques as DDT are effectively used, namely diadynamic currents, electrophoresis with certain drugs, and also due to the probe embedded inside. It must be understood that each of the presented methods will not directly affect the problem area of ​​the esophagus, because it is extremely difficult to reach it.

However, this is how the phrenic nerve is stimulated, which will also innervate the esophagus. Electrodes, through which current is supplied, must be applied to the region of the cervicothoracic spine from behind. While the second is behind the angle in the lower jaw area. Thus, from seven to 10 procedures are carried out every day or every other day.

Electrophoresis with medicines carried out similarly, however, certain preparations are applied to the cuff with electrodes as an additional measure of influence. It is they who can inhibit the excessive production of hydrochloric acid, which will gradually lead to a calmer work of the esophagus.

According to experts, there are changes such as improved blood supply to tissue structures and internal organs. In addition, we are talking about healing processes that will occur much faster. Also, a person notices, albeit a slight, but still noticeable analgesic effect.

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1. Can cancer be prevented?
The occurrence of a disease such as cancer depends on many factors. No one can be completely safe. But everyone can significantly reduce the chances of a malignant tumor.

2. How does smoking affect the development of cancer?
Absolutely, categorically ban yourself from smoking. This truth is already tired of everyone. But quitting smoking reduces the risk of developing all types of cancer. Smoking is associated with 30% of cancer deaths. In Russia, lung tumors kill more people than tumors of all other organs.
Eliminate tobacco from your life - the best prevention. Even if you smoke not a pack a day, but only half, the risk of lung cancer is already reduced by 27%, as the American Medical Association found.

3. Does it affect excess weight to the development of cancer?
Keep your eyes on the scales! Overweight affect not only the waist. The American Institute for Cancer Research has found that obesity contributes to the development of tumors in the esophagus, kidneys, and gallbladder. The fact is that adipose tissue serves not only to store energy reserves, it also has a secretory function: fat produces proteins that affect the development of a chronic inflammatory process in the body. And oncological diseases just appear against the background of inflammation. In Russia, 26% of all cancer cases are associated with obesity.

4. Does exercise help reduce the risk of cancer?
Set aside at least half an hour a week for exercise. Sport is on the same level as proper nutrition when it comes to cancer prevention. In the US, a third of all deaths are attributed to the fact that patients did not follow any diet and did not pay attention to physical education. The American Cancer Society recommends exercising 150 minutes a week moderate pace or two times less, but more active. However, a study published in the journal Nutrition and Cancer in 2010 proves that even 30 minutes is enough to reduce the risk of breast cancer (which affects one in eight women in the world) by 35%.

5.How does alcohol affect cancer cells?
Less alcohol! Alcohol is blamed for causing tumors in the mouth, larynx, liver, rectum, and mammary glands. Ethyl alcohol breaks down in the body to acetaldehyde, which then, under the action of enzymes, turns into acetic acid. Acetaldehyde is the strongest carcinogen. Alcohol is especially harmful to women, as it stimulates the production of estrogen - hormones that affect the growth of breast tissue. Excess estrogen leads to the formation of breast tumors, which means that every extra sip of alcohol increases the risk of getting sick.

6. Which cabbage helps fight cancer?
Love broccoli. Vegetables are not only part of a healthy diet, they also help fight cancer. This is why recommendations for healthy eating contain the rule: half daily ration should be fruits and vegetables. Especially useful are cruciferous vegetables, which contain glucosinolates - substances that, when processed, acquire anti-cancer properties. These vegetables include cabbage: ordinary white cabbage, Brussels sprouts and broccoli.

7. Which organ cancer is affected by red meat?
The more vegetables you eat, the less red meat you put on your plate. Studies have confirmed that people who eat more than 500 grams of red meat per week have a higher risk of developing colon cancer.

8. Which of the proposed remedies protect against skin cancer?
Stock up on sunscreen! Women aged 18-36 are particularly susceptible to melanoma, the deadliest form of skin cancer. In Russia, in just 10 years, the incidence of melanoma has increased by 26%, world statistics show an even greater increase. Both artificial tanning equipment and the sun's rays are blamed for this. The danger can be minimized with a simple tube of sunscreen. A study published in the Journal of Clinical Oncology in 2010 confirmed that people who regularly apply a special cream get melanoma half as often as those who neglect such cosmetics.
The cream should be chosen with a protection factor SPF 15, apply it even in winter and even in cloudy weather (the procedure should turn into the same habit as brushing your teeth), and also do not expose yourself to the sun's rays from 10 to 16 hours.

9. Do you think stress affects the development of cancer?
By itself, stress does not cause cancer, but it weakens the entire body and creates conditions for the development of this disease. Research has shown that constant worry alters the activity of the immune cells responsible for turning on the fight-and-flight mechanism. As a result, a large amount of cortisol, monocytes and neutrophils, which are responsible for inflammatory processes, constantly circulate in the blood. And as already mentioned, chronic inflammatory processes can lead to the formation of cancer cells.

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Massage and exercise therapy Irina Nikolaevna Makarova

Therapeutic exercise and massage for gastroesophageal reflux disease

A manifestation of gastroesophageal reflux disease is erosive reflux esophagitis of varying severity. A common cause of esophagitis is the reflux of active gastric juice into the esophagus due to insufficiency of the cardia (functional insufficiency of the lower esophageal sphincter). This is the so-called reflux esophagitis, which in most cases is observed in axial esophageal-gastric hernias of the esophageal opening of the diaphragm. With this type of hernia, the abdominal segment of the esophagus and the proximal part of the stomach are displaced through the esophageal opening of the diaphragm into the posterior mediastinum.

The development of insufficiency of the lower esophageal sphincter and the appearance of reflux contribute to:

Increased intra-abdominal pressure (with constipation, flatulence, excessive physical activity and etc.);

Slowdown of the evacuation function of the stomach;

Significant changes in the pH of the contents thrown from the stomach;

Duodenal-gastric reflux;

Traction of the cardial part of the stomach into the chest cavity by longitudinal spastic contractions of the esophagus (with esophagospasm) or due to its cicatricial-inflammatory shortening;

Congenital underdevelopment of connective tissue structures that strengthen the esophagus in the esophageal opening of the diaphragm, or age-related dystrophic changes in the elderly.

When passing through the esophageal opening, the esophagus is connected to the medial crura of the diaphragm by muscle bundles m. phrenicooesophageus and a fibroelastic membrane, so underdevelopment or weakness of the crura of the diaphragm can be the cause of hiatal hernia.

The main clinical manifestations of functional insufficiency of the lower esophageal sphincter are heartburn, belching food, epigastric or retrosternal pain, mild dysphagia.

Treatment of insufficiency of the lower esophageal sphincter and in general gastroesophageal reflux disease should be carried out according to the following scheme (modified by R. Siewert et al.).

1. Activities that enhance the contractions of the lower esophageal sphincter:

Protein food;

Physiotherapy;

drug therapy;

Psychotherapy.

2. Exclusion of factors that inhibit the contraction of the lower esophageal sphincter:

fatty food;

Nicotine and alcohol;

Some drugs, especially anticholinergics.

3. To exclude factors that increase intra-abdominal pressure, it is recommended:

Eating in small portions, slow food, try not to swallow air, do not eat late in the evening, do not take foods that promote increased gas formation, if overweight, try to reduce it;

Avoid tight clothing;

After eating, do not take a horizontal position;

During sleep - a high position of the upper body;

Constipation treatment.

The main tasks of exercise therapy

Normalization of the motor function of the stomach and intestines and the fight against flatulence;

Increased contractility of the lower esophageal sphincter, in the formation of which the legs of the diaphragm are taken;

Increasing the strength of the diaphragm.

Exercise therapy classes are held no earlier than 2–2.5 hours after a meal. At the beginning of the course of treatment, the main starting positions are lying on the back and on the right side on an inclined plane with the head end raised by 15–20 cm.

Much attention is paid to abdominal breathing. At the beginning of treatment, it is necessary to protrude the abdominal wall forward as much as possible during inhalation, fixing this position for 2-3 seconds. During exhalation, the abdominal wall cannot be pulled in, you need to relax it. Such an exercise, reducing pressure in the upper floor of the abdominal cavity, gradually strengthens the diaphragm, its medial legs. After 5-6 days of training, which should be carried out 3-4 times a day for 10 minutes. (with rest pauses of 20–30 seconds), it is recommended to start drawing in the abdominal wall during exhalation, gradually increasing the range of motion. The criterion for the correct execution of this exercise and all the others is the absence of heartburn or belching during the training process. The complex of physical exercises gradually introduces movements with the legs, turns of the torso in I.p. lying on the back, on the right side, and later on the left side, stomach, knees and standing.

In i.p. kneeling and standing, extension, torso to the sides, turns, squats, walking, jogging are performed. For a long time, flexion of the body and all movements that increase pressure under the diaphragm are not recommended. This rule also applies to training on various simulators. After exercises with isometric muscle tension, they are relaxed.

Exercise therapy is most effective for functional disorders and sliding hernia of the esophagus. It should be carried out regularly for at least 2-3 months. 1-2 times a day with a gradual increase in load.

In order to combat flatulence and constipation, self-massage, massage of the abdominal wall with a hockey (tennis) ball, massage of the lumbosacral zone and abdomen, dosed walking, swimming, cycling with an upright position of the torso, games (avoiding torso forward bends) are recommended.

Special physical exercises are performed lying on an inclined plane with a raised head end by 15–20 cm and standing.

1. I.p. lying on your back, legs bent at the knees and hip joints, feet support, one hand on the chest, the other on the stomach. Abdominal breathing. On inspiration, the abdominal wall protrudes more and more each time, and on exhalation it relaxes. For the first 5-6 days, it is not recommended to retract the abdominal wall so that heartburn or belching does not appear. Then, in the absence of these phenomena, you can gradually begin to retract the abdominal wall during exhalation. Run 6-8 times.

2. Lying on your back, legs bent, feet supportive. Without taking your feet off the plane, put your knees to the right, then to the left. Perform 8-12 times in each direction.

3. Lying on your back, arms and legs straight. Alternate lifting slightly bent legs during exhalation (complication - both legs at the same time). 5-10 times with each leg or 8-12 times with both legs at the same time. Do not raise your head, your lower back is pressed!

4. Lying on your back, arms and legs straight. Spread your arms to the sides - inhale, pull one knee to your stomach with your hands - exhale. Don't raise your head. 6-10 times with each leg (complication - both legs are pulled up).

5. I.p. lying on the right side right hand under the head, left - in emphasis in front of him. Abdominal breathing (see exercise 1 for the technique). Run 5-8 times.

6. Lying on the right side. The left hand is raised up, the left leg is laid back. With a swinging movement, change the position of the limbs. Run 8-10 times.

7. Perform the 5th exercise on the left side after 4-6 sessions.

8. Perform the 6th exercise on the left side after 4-6 sessions.

9. Standing. Walking with high hips. Run within 30-40 minutes.

10. Main rack. Raise your arms up and at the same time take your leg back, bend over - inhale. I.p. - exhale. 8-10 times with each leg.

11. Standing. Feet shoulder width apart, arms along the body. Tilts of the torso to the sides, hands slide along it (“pump”). Run 8-10 times in each direction.

12. Standing. Hands on the belt. Turns of the torso to the sides with the abduction of the arm of the same name - inhale. Perform 6-10 times in each direction.

13. I.p. - Same. Squatting on toes with a straight back. Run 8-15 times.

14. Walking with the movement of the arms up, to the sides. Run within 30-60 seconds.

15. Jogging (in the absence of contraindications).

This text is an introductory piece.