Breathing and Digestion

2021-01-07

The breath is an important thing!  Our breath is what defines our state of living, gives life to our being. Good breathing mechanics are vital to our state of health.  

Many people have altered breathing patterns due to things like stress and anxiety, TMJ issues and conditions like asthma. Individuals who have disordered breathing patterns tend to hyperventilate, breathe shallow or hold the breath, not engaging the diaphragm fully.  When the diaphragm is not engaged then we tend to breathe from the chest and rely on what is known as our secondary respiratory muscles, which include muscles of the neck, chest, abdomen and thorax.  Relying on these muscles for breathing and not engaging the diaphragm, the primary respiratory muscle, may for some individuals result in musculoskeletal pain (1, 2).  Dysfunctional breathing patterns may also have an affect the function of the vagus nerve, which helps regulate the parasympathetic nervous control over our body’s organs (also known as viscera) (3).

So, how may this potentially affect our digestion?

The diaphragm is a striated skeletal muscle and when we do not use it may become weak or tense.  The diaphragm ideally, when engaged in breathing, should expand during inspiration creating pressure with the thoracic and abdominal cavities and deflate on expiration causing relaxation. This action of the diaphragm expanding and deflating gently massages the abdominal organs encouraging movement of food through the digestive tract (known as peristalsis) and aids circulation and lymphatic flow. 

The diaphragm also has 3 cavities or hiatus’ (openings) through which pass the aortic and vena cava blood vessels, responsible for circulating blood through the body, and additionally the oesophagus.  Dysfunction in the diaphragm may result in symptoms like acid reflux, with some studies showing that certain breathing exercises and diaphragm release may help manage symptoms (4,5). 

When we utilise belly breathing, we also switch on the parasympathetic part of the autonomic nervous system which is vital for good digestion which is sometimes dubbed as the state of rest and digest (3, 6). 

To help improve our breathing and enter a more parasympathetic relaxed state we can employ the breathing exercise below.

- Lie comfortably on your back with a pillow under your knees and head or seated on a chair.

- Place one hand on your chest and one on your abdomen.

- Begin by slowly breathing in through your nose. Keep your breathing slow, quiet and soft throughout. It should feel like you want to take a bigger breath in but not so that it is stressful or that you feel out of breath (this may take a little time to master so do not worry).  It is better to start with shorter breaths that feel manageable and build up to lengthening them overtime. Counting the breath may help. 

- As you breathe in you should be aware of your abdomen gently expanding meaning you are working your diaphragm.

- As you slowly breathe out your nose you should notice the hand on your abdomen fall and your abdomen become flatter.  As exhalation is associated with stimulating the parasympathetic nervous system, focusing on the out breath, making it slow and long is more of a priority than inhalation in this exercise. 

- The hand on your chest should only be a slight movement during the breathing cycle.

- Try to keep your breath in a regular rhythm. 

- Practice this 1-2 times per day for 5-10 minutes. 

References

1. Wirth B., Amstalden M, Perk M, Boutellier U, Humphreys BK. Respiratory dysfunction in patients with chronic neck pain - influence of thoracic spine and chest mobility. Man Ther. 2014;19(5): 440-444.

2. Dimitriadis Z, Kapreli E, Strimpakos N, Oldham J. Respiratory weakness in patients with chronic neck pain. Manual therapy. 2012; 18(3): 248-53.

3. Brown, RP, and Gerbarg, PL. Yoga breathing, meditation and longevity. Ann. N Y Acad. Sci. 2009; 1172, 54–62.

4. Nobre e Souza, MA, Vitorino Lima, MJ, et al, Inspiratory muscle training improves antireflux barrier in GERD patients. Am J Physiol Gastrointest Liver Physiol. 2013; 305: G862–G867.

5. Martínez-Hurtado, I., Arguisuelas, MD, Almela-Notari, P, et al. Effects of diaphragmatic myofascial release on gastroesophageal reflux disease: a preliminary randomized controlled trial. Sci Rep. 2019; 9, 7273.

6. Browning, KN, Verheijden, S, and Boeckxstaens, GE. The vagus nerve in appetite regulation, mood and intestinal inflammation. Gastroenterology. 2016; 152, 730–744.