Adherence and recruitment issues.

To evaluate the effects of osteopathic manipulative treatment in patients affected by symptoms related to gastro-oesophageal reflux disease (GERD)

Inclusion Criteria:

• Retrosternal burning sensation and/or regurgitation
• Diagnosis of reflux with any methodology
• Duration of symptoms for more than 3 months
• Taking short or long-term proton pump inhibitors (as needed, treatment start date and expected end date, mg, drug name)
• With or without esophagitis
• With or without hiatal hernia
• With or without helicobacter pylori
• GERDQ questionnaire > 8 points

Exclusion Criteria:

• neoplastic pathologies
• patients who have undergone surgery for GERD
• systemic pathologies (rheumatic, infectious conditions, feverish state, vascular alterations, endocrine diseases including diabetes, metabolic and neoplastic syndromes),
• patients already undergoing manipulative therapy for reflux
• patients with active gastric ulcers
• congenital or acquired immune diseases
• allergic state of any kind
• pregnancy
• use of intrauterine device
• patients undergoing corticosteroid therapy
• patients already subjected to manual/respiratory therapy in the last 3 months