Manual Therapy Effects on Upper and Lower Esophageal Sphincter Pressures

Manual Cervical Traction and Trunk Stabilization Causes Significant Changes in Lower and Upper Esophageal Sphincter

The aim of this study is to test the influence of manual cervical traction and chest stabilization maneuvers on pressures in upper and lower esophageal sphincters.

High Resolution Manometry (HRM) will be used to measure pressure changes in upper esophageal sphincter (UES) and lower esophageal sphincter (LES) during manual cervical traction and trunk stabilization maneuvers. 50-55 gastroesophageal reflux disease (GERD) subjects will participate in the study. UES and pressures will first be measured in relaxed supine position then, during manual cervical traction and finally, the subjects will undergo manual positioning of the trunk into neutral position and LES and UES pressures will be measured again.

Inclusion Criteria:

• Gastroesophageal reflux disease

Exclusion Criteria:

• Previous gastro- esophageal surgery
• Concomitant other chronic disease that would affect esophageal motility
• Esophageal structural pathology
• Massive hiatus hernia