Background and aims Several study have been reported that modifying vagus nerve control of transient lower esophageal sphincter relaxation can induce improvement of gastroesophageal reflux disease (GERD). Our aim was to evaluate the efficacy of osteophatic treatment (OMT) in infants with GERD.
Methods We enrolled 40 infants (M/F:24/16), age ranged 1–18 months (median 4 month) attending for persistent reflux. Each patient performed I-GERQ-R questionnaire and ultrasonography of the gastro-esophageal junction before and after treatment. The ultrasound score was 0 to 3 on the basis of severity of reflux (number of reflux episodes in 10 min). Moreover each patient did an osteophatic treatment consisting in an extensive physical examination, to evaluate TART parameters (T = tissue texture changes; A = asimmetry; R = restriction of motion; T = tenderness). Then, a specific therapeutic intervention was chosen, treating only the parts of the body presenting greater TART modifications.
Results All the somatic dysfunctions observed before OMT (at the scale 32/40 patients, the condyles 36/40 patients, the occipito-mastoid suture 36/40 patients; the stomach 22/40 patients, the small epiploon 30/40 patients) disappeared after treatment. The average score of I GERQ-R questionnaire before and after treatment was 22.7 ± 4.7 and 17.2 ± 4.5 respectively (p < 0.05). In 29 (72.5%) patients we found an improvement of ultrasound parameters (mean score before and after treatment was 1.7 ± 0.8 and 0.7 ± 0.7 respectively; p < 0.05).
Conclusion OMT could be considered as an alternative treatment in infants with gastroesophageal reflux. Further data are needed to confirm our hyphothesis.