Efficacy of the Bridge Dry Swallowing Exercise for Refractory Gastroesophageal Reflux Disease

Background Gastroesophageal reflux disease (GERD) is a condition characterized by reflux of gastric contents, leading to damage to the esophageal mucosa and/or unpleasant symptoms, with a global prevalence of 13%. Although acid-suppressive medications are currently the most effective treatments for GERD, they may be ineffective against its symptoms. We therefore investigated the efficacy of a physical exercise program for the treatment of intractable GERD symptoms. Methods Fifteen participants who underwent upper gastrointestinal endoscopy were included in this study. They received acid-suppressive drugs for more than eight weeks and had a score of >_ 8 on the Frequency Scale for the Symptoms of GERD (FSSG). Participants were instructed to perform a 2-week interventional exercise program comprising drinking saliva 10 times in the bridge position (bridge dry swallowing exercise). This involved swallowing saliva without any food or drink while the hip was raised in the supine position. Changes in the FSSG scores after exercise were examined (UMIN000047829). Results Among the 15 participants, 7 were men, with a median age of 59 years old. Each participant had mild reflux esophagitis or no mucosal injuries. All participants completed the exercise program safely. Of the 15 participants, 13 demonstrated an improvement in the FSSG score after the intervention. The total FSSG score improved significantly from a median of 17 to 11 (p <0.001). Five participants discontinued acidsuppressive drugs after the intervention ended. Conclusions Bridge dry swallowing exercises can improve the intractable symptoms of GERD. However, further studies are required to verify its efficacy and safety.