Franzen Thomas, Tibbling Lita Ingrid, Hägg Mary Karin
a Experimental Medicine, Surgery , Linköping University, Vrinnevi Hospital , Norrköping , Sweden.
b Experimental Medicine, Surgery , Linköping University, University Hospital , Linköping , Sweden.
Acta Otolaryngol. 2018 Nov;138(11):1004-1008. doi: 10.1080/00016489.2018.1503715. Epub 2019 Jan 10.
Many physicians insist patients lose weight before their hiatal hernia (HH) condition and related symptoms including intermittent esophageal dysphagia (IED) and gastroesophageal reflux disease (GERD) can be treated, but it is not proven that body mass index (BMI) has an impact on exercise-based treatment of HH-related symptoms.
AIMS/OBJECTIVES: To investigate whether BMI has significance on IQoro® neuromuscular training (IQNT) effectiveness in treating HH-related symptoms.
Eighty-six patients with sliding HH and enduring IED and GERD symptoms, despite proton pump inhibitor medication, were consecutively referred for 6 months' IQNT comprising 11/2 minutes daily. They were grouped by BMI which was recorded before and after IQNT, as were their symptoms of IED, reflux, heartburn, chest pain, globus sensation, non-productive cough, hoarseness, and misdirected swallowing. They were also assessed on food swallowing ability, water swallowing capacity and lip force both before and after treatment.
After IQNT, all BMI groups showed significant improvement (p < .001) of all assessments' and symptoms; and heartburn, cough and misdirected swallowing were significantly more reduced in the severely obese.
IQNT can treat HH-related IED and GERD symptoms as successfully in moderately or severely obese patients as in those with normal bodyweight.
许多医生坚持认为，患者在治疗食管裂孔疝（HH）及其相关症状（包括间歇性食管吞咽困难（IED）和胃食管反流病（GERD））之前需要减肥，但尚无证据表明体重指数（BMI）对基于运动的HH相关症状治疗有影响。
研究BMI对IQoro®神经肌肉训练（IQNT）治疗HH相关症状有效性的影响。
86例滑动性HH患者，尽管服用质子泵抑制剂，但仍有持续的IED和GERD症状，连续接受为期6个月的IQNT治疗，每天1.5分钟。根据BMI分组，记录IQNT前后的BMI、IED、反流、烧心、胸痛、球感、干咳、声音嘶哑和误咽症状。治疗前后还评估了食物吞咽能力、水吞咽能力和唇部力量。
IQNT治疗后，所有BMI组的所有评估和症状均有显著改善（p < 0.001）；重度肥胖患者的烧心、咳嗽和误咽症状改善更为显著。
IQNT在中度或重度肥胖患者中治疗HH相关IED和GERD症状的效果与正常体重患者一样成功。
