More acid reflux than you would think

FOR IMMEDIATE RELEASE

Structural, Breathing, Posture, and Nervous System Factors May Influence Hiatal Hernia and Chronic Reflux—Beyond Medication Alone

PORTSMOUTH, NH — December 28, 2025 — Hiatal hernia and chronic digestive discomfort affect a substantial portion of adults in the United States. Clinical literature suggests hiatal hernias are present in roughly 20% of adults and may be identified in nearly 30% of individuals undergoing upper endoscopy, while reflux-related symptoms and conditions (including GERD and chronic heartburn) are estimated to affect 18–28% of U.S. adults.

Despite how common these issues are, many people still aren’t told about the physical and neurological factors that may contribute to ongoing symptoms—especially when endoscopy confirms irritation but the treatment plan stops at “take meds and avoid trigger foods.”

At Port City Chiropractic in Portsmouth, New Hampshire, Dr. Shawn Shapiro emphasizes a broader functional perspective: in many cases, persistent reflux symptoms may be influenced by a combination of diaphragm mechanics, breathing patterns, posture, spinal/rib mobility, and nervous system regulation—factors that can exist alongside (and sometimes reinforce) chronic discomfort.

How Hiatal Hernia Can Affect the Body

A hiatal hernia occurs when part of the stomach shifts upward through the diaphragm. This can disrupt pressure regulation beneath the sternum and may alter normal breathing mechanics. People may notice:

• Heartburn and reflux (especially after meals or when lying down)
• Chest tightness or pressure under the breastbone
• Post-meal discomfort or upper abdominal pressure
• Shallow breathing or difficulty taking a deep breath comfortably

Over time, chronic stress patterns, ribcage restriction, and posture strain can reduce diaphragm mobility—potentially increasing mechanical stress around the stomach-esophagus junction.

Medication Reliance and Unresolved Symptoms

Many individuals manage symptoms with proton pump inhibitors (PPIs) such as Prilosec or Nexium, or with antacids like Tums. While these approaches can reduce symptoms for many people, long-term symptom management without addressing contributing mechanical or neurological factors may lead to incomplete relief.

“People often tell us they’ve had tests confirming irritation, but no one explained what could be mechanically driving the pressure and reflux patterns,” said Dr. Shawn Shapiro, Doctor of Chiropractic and owner of Port City Chiropractic. “For some patients, improving diaphragm movement, breathing mechanics, posture, and nervous system balance can be a meaningful part of a more complete strategy.”

Long-Term Considerations

Chronic reflux and ongoing irritation of the esophagus have been associated with Barrett’s esophagus, a condition involving abnormal cellular changes and linked to increased risk of esophageal cancer over time. Health professionals commonly emphasize that persistent symptoms deserve careful evaluation, particularly when discomfort is ongoing or worsening.

A Functional Perspective: Structure + Breathing + Nervous System Regulation

Digestive function isn’t only about acid level—it also depends on coordinated motion and regulation. From a functional standpoint, factors that may influence symptom persistence include:

• Diaphragm tension or restriction
• Ribcage and thoracic spine mobility
• Forward-head posture and slumped sitting
• Breathing patterns (especially upper-chest “stress breathing”)
• Autonomic nervous system imbalance (fight-or-flight vs. rest-and-digest)

Supportive care approaches sometimes discussed in clinical settings may include chiropractic adjustments, manual techniques focused on mobility (including diaphragm-related work), and breathwork strategies designed to reduce chronic bracing and improve mechanics. Some clinics also use adjunctive modalities such as low-level laser (cold laser) as part of a broader functional plan.

Manual “Reduction” Approaches: Osteopathic Influence and Manipulation Training

In some clinical traditions, clinicians trained in osteopathic manipulative treatment (OMT) use hands-on methods intended to normalize tension patterns around the diaphragm and gastroesophageal junction. Published case literature has described symptom improvement—and in one report, endoscopic findings consistent with resolution—following OMT-based care in a patient with hiatal hernia.

In chiropractic-related manual therapy education, hands-on diaphragm and visceral-oriented methods are also discussed in some circles. For example, Logan University resources (formerly Logan College of Chiropractic) include references within applied kinesiology materials to a “hiatal hernia/GERD technique” involving the diaphragm.

Port City Chiropractic notes that manual approaches are not appropriate for everyone, should be performed only by properly trained clinicians, and should be considered complementary to medical evaluation—particularly when symptoms are severe, persistent, or associated with red flags.

Education, Awareness, and Next Steps

Port City Chiropractic encourages individuals experiencing ongoing reflux symptoms to consider a broader conversation—one that includes not only diet and medication, but also mechanics, posture, breathing, and stress physiology.

“When someone has had symptoms for years, it’s worth asking: what’s continuously creating pressure and irritation patterns?” Dr. Shapiro added. “Sometimes the best next step is looking at the whole system.”

About Port City Chiropractic

Port City Chiropractic is located in Portsmouth, New Hampshire and provides chiropractic care and functional wellness-focused support for patients seeking improved mobility, posture, nervous system regulation, and overall function.

Media Contact

Port City Chiropractic

100 Borthwick Avenue, Suite 130

Portsmouth, NH

Phone: 603-433-2447

Website: www.Portcitychiro.com

Email: Dr.shapiro@portcitychiro.com

Reference Data and Sources (as provided)

• Hiatal hernia prevalence: https://www.ncbi.nlm.nih.gov/b...
• Hiatal hernia findings during upper endoscopy: https://pubmed.ncbi.nlm.nih.go...
• GERD prevalence in the United States: https://pubmed.ncbi.nlm.nih.go...
• Proton pump inhibitor safety and long-term use (FDA): https://www.fda.gov/drugs/post...
• Barrett’s esophagus and cancer risk (NIDDK): https://www.niddk.nih.gov/heal...
• Diaphragm function and breathing mechanics: https://pubmed.ncbi.nlm.nih.go...

Medical Disclaimer: This release is for educational purposes and does not provide medical advice. Do not stop or change prescription medication without guidance from your prescribing clinician. Seek urgent medical evaluation for chest pain, difficulty breathing, trouble swallowing, vomiting blood, black/tarry stools, unexplained weight loss, or rapidly worsening symptoms.