Chiropractic management of heartburn, dyspepsia and reflux in chronically symptomatic adults

Abstract

Background. Chiropractic has traditionally treated visceral symptomatology; however, only anecdotal evidence exists regarding heartburn, dyspepsia or reflux (HDR). Objectives. This investigation aimed to build on a pilot study showing positive effects from chiropractic management of HDR. A review of the neuroanatomical and physiological rationale for chiropractic management is followed by comparison of outcomes in different chiropractic treatment interventions on HDR and a control group receiving no intervention. Setting. 18 UK chiropractic clinics. Methods. Routinely presenting patients who had not received manipulation for 12 months were recruited using a questionnaire to identify exclusion criteria. Controls were recruited from former patients of two participating clinics. A 7- point Likert scale was used to grade symptom frequency and severity and detail medication use. At presentation and 1 month after treatment conclusion. Treating chiropractors reported the nature, frequency and duration of interventions. Results. 1,441 patients were eligible (88.5%); of these, 207 had GORD symptoms (14.4%). 155 received treatment, 52 were control. Incidence was similar between age groups; prevalence was greater in females (58%). The treatment group improved in all variable compared to control (p < 0.001). This effect was greater in patients treated using specific visceral protocols compared with spinal manipulation alone (p < 0.05). Including dietary/lifestyle advice did not affect outcomes. Conclusions. Notwithstanding identified biases, including non-randomisation of the control group, this trial suggests that chiropractic may have a role in management of patient with symptoms of HDR. Techniques involving visceral protocols had significantly greater effect than ‘standard’ chiropractic manipulation alone. Although the trial has good applicability to daily chiropractic practice, a randomised controlled trial in patients with endoscopically confirmed diagnoses is needed to confirm cause and effect and isolate mechanisms of action.

Date of Award	2010
Original language	English
Supervisor	Peter McCarthy (Supervisor) & Susan King (Supervisor)