Researchers have tested a type of massage to help reduce symptoms of GERD.

In this era of antibiotic resistance and opioid addiction, finding alternatives to drugs is of growing interest to scientists, doctors, and the public at large.

A group of researchers recently investigated a drug-free way to alleviate gastroesophageal reflux disease (GERD), or acid reflux.

Hailing from the Departments of Physical Therapy, Medicine, and Surgery of the Universidad CEU Cardenal Herrera of Valencia in Spain, they recently published their findings in the journal Scientific Reports.

The scientists focused their study on people with GERD, a common condition that affects around 18.1–27.8% of adults in the United States.

Gastroesophageal reflux occurs when the contents of the stomach, including stomach acid, travel up into the esophagus. This can cause the unpleasant burning sensation that many people call heartburn.

For people with GERD, gastroesophageal reflux can be a regular occurrence that significantly impacts their quality of life.

Current treatment options generally involve the long-term use of proton pump inhibitors (PPIs). Although these drugs are effective, they can cause adverse events in some people and may increase the risk of chronic kidney disease.

The scientists involved in the most recent study investigated whether a type of massage called myofascial release (MFR) might relieve the symptoms of GERD.

What is MFR?

MFR focuses on the fascia. Prof. María Dolores Arguisuela, research co-director, explains that “the fascia is a tissue of the body that wraps around all structures — muscles, bones, vessels, organs — and has the function of supporting or sustaining, transmitting tensions, and sliding between planes.”

According to the authors of a review of MFR, the technique is a “manual therapy that involves the application of a low load, long duration stretch to the myofascial complex, intended to restore optimal length, decrease pain, and improve function.”

The researchers wanted to understand whether MFR could reduce gastroesophageal reflux, improve quality of life, and minimize the number of PPIs that people needed to take.

They explain that the MFR intervention they designed to use in this study aimed to “stretch the diaphragm muscle fibers.”

The diaphragm is a muscular barrier that separates the abdomen from the chest. The scientists focused on massaging the fascia around the diaphragm because it sits just above the stomach and plays an important role in stopping stomach acid from traveling into the esophagus.

Massage vs. reflux

To investigate, they recruited 30 people, aged 18–80, with GERD. Half of the participants received MFR from a highly experienced physical therapist, and the other half received a sham procedure.

Each participant received four 25-minute sessions at a cadence of twice per week for 2 weeks.

During the MFR sessions, the therapist used six techniques that targeted the fascia of the diaphragm; the sham treatment involved similar techniques, but the practitioner did not apply pressure to the fascia.

The scientists assessed the impact of MFR using three measures:

• severity and frequency of GERD symptoms, measured using a 12-item questionnaire
• quality of life, assessed using a 36-item questionnaire
• PPI usage, measured in milligrams of drugs the participants took

The researchers repeated these measures before the first MFR session, after 1 week of MFR, and at the 4-week mark (2 weeks after the final MFR session).

Compared with those in the sham group, at the 4-week mark, those in the experimental group had a significant improvement in symptoms and self-rated quality of life. Similarly, participants in the MFR group needed to take significantly fewer PPIs. The study authors explain:

“These preliminary findings indicate that the application of the MFR protocol we used in this study decreased the symptoms and PPIs usage and increased the quality of life of patients with nonerosive GERD up to 4 weeks after the end of the treatment.”

Limitations and concerns

This was only a small preliminary trial, so scientists will need to investigate this effect using many more participants.

The authors also note that their study did not take any physical measurements to assess whether the diaphragm was, indeed, blocking the esophagus more effectively.

They also note the challenges of studying a manual therapy, because as the practitioner responds to the needs of each person’s body, every therapy session is different; on this note, they write, “In this sense, the use of manual therapy is itself a study limitation.”

Another shortfall is the limited follow-up; it would be interesting to measure how long the benefits of MFR can last.

However, despite the limitations, the results are encouraging. The researchers write:

“[T]reatment with MFR techniques has no side effects and could become a therapeutic alternative or complement in patients requiring long-term PPIs use or who want or need to avoid PPI medications because of their possible side effects.”

Nausea is a feeling in the mouth, back of the throat, and stomach that many people refer to as feeling sick. Nausea can sometimes lead to vomiting. Other common symptoms that can accompany nausea are dizziness, difficulty swallowing, excessive saliva production, and clammy skin.

Loss of appetite means not feeling hungry, eating much less than usual, or not eating at all. A person may have no interest in food or not want to eat. Although it is often a short-term problem, prolonged appetite loss can result in weight loss, tiredness, and dehydration.

A person may experience nausea or a loss of appetite because of a medical condition or the treatment they are receiving for it. Symptoms can also be food-related and occur because of food poisoning or an allergy. In some cases, loss of appetite and nausea can result from intensive exercise or have a psychological cause, such as stress.

Food poisoning

Nausea and loss of appetite are common symptoms of food poisoning.

Bacteria and viruses can contaminate food and cause food poisoning. Common symptoms include nausea and loss of appetite as well as stomach cramps, fever, vomiting, and diarrhea.

Unless food poisoning is severe, it is usually advisable to treat the condition at home because it can be contagious.

Replacing lost fluids is essential, and a person should drink plenty of water and use oral rehydration solutions if vomiting and diarrhea are severe. Resting and gradually reintroducing plain foods, such as rice or toast, can aid recovery.

A person should see a doctor if they have:

• a high temperature
• blood in the stool
• signs of dehydration
• diarrhea that lasts for 3 days or more

Oral rehydration solutions are available to purchase online.

Food allergy or intolerance

An allergic reaction to a particular food can cause nausea, which often precedes stomach cramps or vomiting. Other common symptoms include watery eyes, sneezing, itchy skin, hives, and swelling, which happen shortly after eating the food.

If a person suspects that they have a food allergy, an immunologist can offer testing and advice. It is important to avoid foods that can cause an allergy and take care when buying food or eating out. A person may need a prescription for an epinephrine auto-injector, such as an EpiPen, if the allergy is serious.

Medication

Some medications can have side effects that cause a loss of appetite or nausea. These include the following.

Nausea:

Loss of appetite:

• chemotherapy
• medication for attention deficit hyperactivity disorder (ADHD)
• antibiotics

Taking medication with a snack can help prevent nausea. Alternatively, taking it before bed can allow a person to sleep through the side effects. Lying flat can make a person more likely to feel nauseated, so using an extra pillow to elevate the body may be beneficial.

If nausea or loss of appetite due to medication is affecting a person’s daily life or well-being, a doctor may be able to amend the dosage or prescribe an alternative treatment.

Psychological causes

Both nausea and loss of appetite have a link with psychological issues, such as stress and anxiety. A person who is very stressed or anxious may lose their appetite.

Nausea is a recognized symptom of anxiety disorders. Other physical symptoms can include shaking, sweating, rapid heartbeat, and difficulty breathing.

Treatment options for anxiety include therapy and medication. Support is available from advocacy organizations, such as the Anxiety and Depression Association of America. They offer information and advice and also provide links to peer support groups.

Exercise

Some people may experience nausea or loss of appetite after exercising. These symptoms are most common in endurance athletes, such as marathon runners.

There are many possible reasons why exercise could lead to nausea. Strenuous exercise can take blood away from the stomach to other parts of the body, which can make a person feel nauseated. Drinking too much or too little water can also cause a person to experience nausea.

People can often avoid feeling sick or vomiting by waiting 1 to 2 hours after eating before exercising. Other ways to reduce the likelihood of nausea include avoiding a sudden finish to an exercise session, warming up and down, and not overexerting the body.

A person may notice a loss of appetite during or after exercise, but this should return after completing the exercise session and resting.

Pregnancy

Pregnant women may find that drinking fluids throughout the day helps reduce nausea.

Nausea and appetite changes are common symptoms of pregnancy. Nausea and vomiting usually start within the first 9 weeks of pregnancy and go away after the first 14 weeks.

The American College of Obstetricians and Gynecologists recommend making lifestyle changes to help with nausea, such as:

• eating small, regular meals and choosing bland foods
• drinking fluids regularly throughout the day
• avoiding smells that trigger nausea
• drinking beverages that contain real ginger, such as ginger tea or ginger ale
• eating some dry crackers before getting out of bed in the morning

For some women, nausea and vomiting can be more severe and may last for the whole pregnancy. A woman may wish to seek medical advice and treatment if this is the case.

Appetite loss and eating less can lead to weight loss, which can affect the health of the woman and the fetus. If nausea and appetite loss have this effect, medical advice can be helpful. A doctor may be able to prescribe medication to reduce nausea.

Postoperative nausea

Nausea and vomiting are recognized side effects of anesthesia, and they can affect some people after an operation. The type of surgery can affect the likelihood of these symptoms occurring.

If a person has a risk of postoperative nausea and vomiting, doctors may give them medication before, during, or after surgery.

Loss of appetite may occur as a person recovers from surgery. In addition to staying hydrated, eating little and often is key to recovery and can help a person feel well after the procedure.

Cancer

Nausea can affect people who have cancer, with possible causes including bowel obstruction and infection.

Some cancer treatments can also make a person feel sick. For example, chemotherapy is a particularly common cause of nausea. Doctors will often prescribe medication to help lessen this side effect.

Some people who have cancer may have a loss of appetite. Common causes are a change in a person’s sense of smell or taste, feeling full, and the side effects of treatment.

A cancer team can provide advice if a person has little or no appetite. They may recommend eating little and often, opting for foods that are high in calories, or cutting food into smaller pieces so that it is easier to swallow. Proper nutrition is an integral part of treatment, and a person will usually receive support to help them eat well.

Risks

Loss of appetite and nausea can be damaging to health in the long term. If a person experiences these symptoms for an extended period, they may wish to seek medical advice.

If nausea leads to vomiting, it can cause dehydration. Loss of appetite may mean that someone is not taking in enough fluids through food sources, and this can also lead to dehydration.

Staying hydrated is important for the body to function. If a person is feeling nauseated, they may prefer to take small sips of water regularly throughout the day.

Not eating enough can lead to weight loss, which can be damaging to health. Without sufficient nutrients, the body may not be able to work properly.

Feeling nauseated can interrupt daily life. It may make it more difficult for a person to concentrate at work or school. Nausea can also cause stress, worry, and other physical symptoms, such as stomach pain.

Home remedies

Drinking ginger tea can help settle the stomach.

Although there are few home remedies that scientists have tested and proven to work, some of the following may provide relief from loss of appetite and nausea:

• Drinking ginger tea or ginger ale containing root ginger can help settle the stomach.
• Mint tea, sweets, or chewing gum may help with nausea.
• Drinking small sips of fluids can help with symptoms of nausea, such as excess saliva.
• Eating plain foods may prevent feelings of nausea.
• Small, regular meals and snacks are easier for a person to eat if they have appetite loss.
• Lying down in a dark, cool room can reduce the severity of nausea.

When to see a doctor

If symptoms persist for more than 1 to 2 days with no clear cause, a person may wish to seek medical advice to avoid damaging their health.

People who have food poisoning should seek medical advice if they have blood in their stool, a fever, or signs of dehydration. It is also important for people who suspect that they have a food allergy to seek medical advice.

If a person experiences ongoing symptoms, they may wish to take medication to restore their appetite. Doctors are most likely to prescribe this medication if a person’s loss of appetite is due to them taking a different medicine for a separate condition.

Takeaway

Most people only experience nausea and loss of appetite for a short period. If these symptoms persist, they can be distressing and may pose a risk to health.

Keeping a record of symptoms and when they happen may help a doctor make a diagnosis. Doing this can also help a person spot potential triggers of nausea or appetite loss, such as exercise, meal times, or particular foods.

Making some simple lifestyle changes may help people prevent loss of appetite and nausea.