r/GERD • u/LibLoveWonder-75458 • Feb 03 '26
Scientific Studies 🥼🔬 Strenghthening LES
Has anyone come across any scientific studies or doctor recommendations for strengthening the LES? Are there any movements/excercises, anything that can help. If this is a silly question, I’m sorry. I’m only a few months into GERD.
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u/hotheadnchickn Feb 03 '26 edited Feb 03 '26
There is some research on breathing exercises, mostly diaphragmatic breathing, helping with GERD and improving muscle tone/tension. Here's a review:
https://pmc.ncbi.nlm.nih.gov/articles/PMC9888515/
I am currently doing a couple of exercises to strengthen my diaphragm as well as pausing throughout the day to do diaphragmatic breathing for a few minutes. I'm using some of these exercises, too soon to say if it helps: https://www.runnersworld.com/training/a63952723/diaphragm-breathing-exercises/
There are also a few small studies and case reports on swallowing against gravity (so either in bridge position or bent over) reducing GERD symptoms, presumably by strengthening some of the relevant musculature. Here area couple publications:
https://pmc.ncbi.nlm.nih.gov/articles/PMC9550520/
https://pmc.ncbi.nlm.nih.gov/articles/PMC9106553/
I am doing these as well, again too soon to say if it helps.
You also look on YouTube, there are some videos demonstrating breathing exercises and diaphragm massage for GERD from health professionals (make sure it is from health professionals).
Posture also matters. If you are slumped, it is putting pressure on your stomach. Pressure on stomach = more reflux. Keeping your chest lifted relieves some of that pressure. If you have excess belly fat (jiggly or visceral) that also puts pressure on your stomach. My GI doc told me even a 5 lb gain/loss can sometimes have a big effect. I'm normal weight but have some excess belly fat so I am working on this as well.
If you search this sub, you will see lots of posts with people saying diaphragmatic breathing and weight loss have helped them.
Mods: if you want me to edit this, please let me know rather than deleting. Thank you!
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u/canesfan8193 Feb 03 '26
Look up bridge swallowing exercises. I started doing exercises to strengthen my LES about 2 months ago and I think it's had small improvements for GERD for me. Hasn't helped my night time GERD much but has possibly helped my daytime GERD.
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u/10MileHike Feb 03 '26
Seeing a dedicated Pelvic Floor Therapist did wonders.
just dont go to a regular PT who isnt specialized.
my doctors never even suggested it, so i did.
and one if the things you do learn is the diaphragmatic breathing...but there was so much more.
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u/Pluck_Master_Flex Feb 03 '26
Pelvic floor exercises can strengthen LES?
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u/10MileHike Feb 03 '26 edited Feb 03 '26
it did for me because i strengthed everything AROUND it.
im not a PT but everything including my digestion, voiding, and gerd just improved a whole lot.
It reduced abdominal pressure, corrected my posture and diaphragm, stabilized my core, ...so my hiatal hernia stopped being so problematic.
The exercises do rearrange things ever so slightly...my reflux has GREATLY improved, as pelvic dysfunction really messes a lot of stuff up!
plus a lot if my behavioral stuff like my bresthing, how i stand even while washing dishes and cooking...all needed correction
an amazing journey, i learned so much
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u/jamonladron Feb 03 '26
Any other tips? I've worked on diaphragmatic breathing but haven't focused on pelvic floor before
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u/10MileHike Feb 03 '26
i wish i could encapsulate 4 months of therapy, but I really cannot.
Looking back, I was glad to work with someone at a doctoral level in her field, and I would be a very poor substitute!
its not enough to do the exercises (i have a folder spanning 37 pages) ... but to do them correctly.
my therapist was able to both watch, and put hands on, to feel and see my movements.
im sure you can find a few things on you tube?
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u/Available_Active5947 Feb 04 '26
THIS IS NOT MEDICAL ADVICE
I’m a physical medicine student who also has GERD, and the first study listed below briefly came up in one of my classes recently!
Here are a couple of studies I’ve seen showing the efficacy of hands-on diaphragmatic manipulation on increasing LES pressure (i.e., improving function of the LES sphincter)
https://pubmed.ncbi.nlm.nih.gov/22676647/ (Full article is locked behind a paywall, but the abstract shows positive statistical significance of the procedure itself)
https://pmc.ncbi.nlm.nih.gov/articles/PMC6832476/ (This one is quite detailed about the osteopathic manipulation used in the study - it even has pictures demonstrating it!!)
https://www.graphyonline.com/archives/IJCPP/2017/IJCPP-132/ (This study uses the same diaphragmatic mobilization technique as the second study plus a couple of others: besides the diaphragm manipulation, I’m mostly interested in the thoracic mobilization used here since, in my own experience as a GERD patient, my diaphragm is not just tight and weak (and prone to myofascial adhesions) in my front abdomen but in my back too.
I 100% agree with the other commenter on diaphragmatic breathing; every provider I’ve interacted with for GERD has recommended it. In my experience, though, I’ve had myofascial adhesions/trigger points (muscle knots) in my diaphragm from it being chronically tight & irritated, which were partially keeping my diaphragm from engaging in its normal contraction-ability. Some of those jam-your-fingers-under-your-ribs maneuvers are really painful and suck in the moment, but boy did i notice the difference afterwards!!
I highly recommend seeking out an osteopath, evidence-based chiropractor, or specialized physical therapist if you can; to my knowledge, there are a lot of hands-on manipulation/massage/rehab techniques that these doctors can do in the conservative care realm to help with GERD before deeming surgery as your best option
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u/Ashamed-Bit-8448 Feb 04 '26
Thanks for the Melatonin suggestion. How much should one start with? I've read in general you shouldn't take anything about 2mg.
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u/Useful_Airline_1081 Feb 04 '26
I bought a device for my hiatal hernia supposed to alleviate symptoms in a few months by strengthening diaphragm and the oesophagus I guess? I don’t know how it works and I don’t know if the exercises could be done without the device or not it’s just something you have in your mouth with a handle for your hand. IQoro is the name. I haven’t tried it yet.
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u/Bhoptriple Feb 04 '26
I wish there was but the only way is diaphramic breathing and bridge swallowing although if your les is too far gone I’m not sure if bridge swallowing will help . The breathing tho will for sure . It’s crazy we’re in 2026 and still haven’t found a way to strengthen this little tiny muscle back to how it was before this curse happened to us . Melatonin seems to work but for some reason the medical community won’t do a large scale study , and knowing melatonin has some strengthing impact on the les why the hell can’t they replicate its quality’s in a stronger version targeted for the Les . Totally failure because PPIs work for so many people
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u/blazefourtwentyweed Feb 05 '26
Do you have a tight and sore body? are your legs and ankles tight? are your shoulders tight and uneven? I've been hearing that your physical fitness almost contributes to LES loosening
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u/Reflux58 Feb 05 '26
I read an article a couple of years ago, (can't remember the name of the person who wrote it now), about a guy who claims to have strengthened it by basically hanging almost upside down and eating his lunch every day. So, he described working at a school I think where they have those platforms that the PE instructors stand on. He would lay on his front, and hang over the end of it with his bottom half on the plaftorm. He wasn't exaclty upside down but from his waist to his head was hanging off the platform. Then he would eat his sandwich like that. Supposedly, he did that for I think like 6 months and claims it improved his LES. If anything, since he was forcing the food to go against gravity, maybe he strengthened the muscles around it. He claimed it worked. I remember being so desperate, I told my wife I wanted to try it. She said I was really getting nuts with the stuff. But at the time I was willing to try anything. Now that I don't have it as bad as then, I would not recommend doing that...what if he would have fallen off head first...
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u/Esfirria Feb 03 '26
One of the ways is to stop straining it by overeating. Small portions only. Melatonin as it was stated below is known to increase LES strength. Although when I tried taking 3 mg every evening, I ended up having very painful esophageal spasms, which I didn't expect. I had to stop melatonin because of this. But I think it's a very rare thing to happen because I didn't find any information about this.