Visceral Physiotherapy For

Patients With GERD & Functional Dyspepsia

 GERD & FUNCTIONAL
DYSPEPSIA IN REVIEW
Pathophysiology and Challenges in The Intervention of
Physiotherapy Approach
Introduction
How Is GERD & Functional Dyspepsia
Defined?



 Gastric Dismotility

Visceral
hypersensitivity
What Do We Know about

Psychological Factors
The Pathophysiology of GERD & FD?

Other Factors
Gut-Brain Axis
1.


What Are the Consequences of GERD &
Functional Dyspepsia?

4 Struggle

3 Concentrating

2 Fatigued

1 Anxious
How Is Coexistence GERD & Functional
Dyspepsia Diagnosed?

•The typical symptoms

and the patient’s history

The exclusion of other

diseases which similar FD
What Are the
Complications of GERD Weight
Loss

& FD?
High
Quality of
Blood
Sleep
Pressure

FD
conditions

Headache
Quality of
and
Life
Migraine

Mood
Disorders
How Is GERD & FD Managed or Treated
By Physiotherapy?
What Is Visceral Physiotherapy?

Jean-Pierre Barral, DO., PT

Developer Of Visceral Manipulation
What Is Concept Of
Visceral Physiotherapy?



Visceral, in
optimal health
depends on the
physiology of
movement


Jean-Pierre Barral, DO., PT

Developer Of Visceral Manipulation
 “
Are All Organs
Moving
!

14
 “
How Is the Stomach
Moving simultaneously?

15
 How Is PT
Assessment Performed
for FD Conditions?
Rebound test

How Is Physical Examination PT

Performed for GERD & FD Conditions?

Hemodynamic test Local Listening test Jean-Pierre Barral, DO., PT

Developer Of Visceral Manipulation
 Jean-Pierre Barral, DO., PT
Developer Of Visceral Manipulation

How Is Visceral Physiotherapy

Performed for GERD & FD Conditions?
How Is Visceral Physiotherapy
Performed for GERD & FD Conditions?
Effect Of Physiotherapy Treatment?
Frequency : 3 Time /Week
Intensity : 7-8 Cycles /
Plane or 21-28 Cycles /
Three-plane with Gentle
Pressure
Time : 20-30 Minute
Type : Stomach
Mobilization, Directly And
Indirectly
FITT Dosage Of
Visceral Physiotherapy Techniques
Reference
1. Asano H, Tomita T, Nakamura K, Yamasaki T, Okugawa T, Kondo T 2017, Prevalence of Gastric Motility Disorders in Patients
with Functional Dyspepsia, Journal of Neurogastroenterology and Motility, Vol. 23 No. 3.
2. Attali, T.-V., Bouchoucha, M., & Benamouzig, R. (2013). Treatment of refractory irritable bowel syndrome with visceral
osteopathy: Short-term and long-term results of a randomized trial. Journal of Digestive Diseases, 14(12), 654–
661. doi:10.1111/1751-2980.12098.
3. Bjorkman DJ 2017, Gastric Motor Abnormalities in Functional Dyspepsia, NEJM Journal Watch.
4. Eguaras N, Lopez ES, Dicastillo OL, Sierra AF, Ricard F & Vaca AOP 2019, Effects of Osteopathic Visceral Treatment in Patient
with Gastroesophageal Reflux: A Randomized Controlled Trial, Journal of Clinical Medicine, Vol. 8(10), 1738.
5. Ford AC, Mahadeva S, Carbone MF, Lacy BE & Talley NJ 2020, Functional Dyspepsia, Journal of Functional Gastrointestinal
Disorders, Vol. 396, Issue 10263, p. 1689-1702.
6. Barral JP & Mercier 2005, Visceral Manipulation, Eastland Press, Inc, Seattle USA.
7. Heller M 2013, Principles of Visceral Manipulation, Dynamic Chiropractic, Vol. 31, Issue 08, No. 16.
8. Rechberger, V., Biberschick, M., & Porthun, J. (2019). Effectiveness of an osteopathic treatment on the autonomic nervous
system: a systematic review of the literature. European Journal of Medical Research, 24(1). doi:10.1186/s40001-019-0394-5.
9. Silva AC, Gonzalez DAB, Oliveira FHM, Andrade AO, & Gomes CAF, Lanza FC, Amorim CF & Politti F 2018, Effect of Osteopathic
Visceral Manipulation on Pain, Cervical Range of Motion, and Upper Trapezius Muscle Activity in Patients with Chronic
Nonspecific Neck Pain and Functional Dyspepsia: A Randomized, Double-Blind, Placebo-Controlled Pilot Study, Evidence-Based
Complementary and Alternative Medicine, Volume 2018.
10. Santos LV, Cordoba LL, Lopes JBP, Oliveira CS, Grecco LAC, Andrade ACBN & Neto HP 2019, Active Visceral Manipulation
Associated with Conventional Physiotherapy in People with Chronic Low Back Pain and Visceral Dysfunction: A Preliminary,
Randomized Controlled, Double-Blind Clinical Trial, Journal of Chiropractic Medicine, Vol. 18, No. 2, p. 79-89.
11. Jean-Pierre Barral, Understanding the Message of Your Body:How to Interpret Physical and Emotional Signals to Achieve Better
Health. California: North Atlantic Books. U.S. 2007.
 “
TERIMA KASIH
Any Questions?