Strength training solved my acid reflux
Tom Mills fixed a decade of sore throats and tooth erosion with a mouthguard that gave his nerves and muscles a workout
For 10 years, Tom Mills would wake most days with an irritated throat and phlegm he couldn’t clear. Like an estimated 20 per cent of British adults, he was suffering with acid reflux.
This is a condition where digestive acid, bile and enzymes escape into the oesophagus, the muscular tube connecting the mouth and stomach.
Symptoms range from heartburn, bad breath, coughing, a hoarse voice and sore throat to bloating, phlegm and even dental and lung damage, depending on whether it reaches the chest, lungs, throat or mouth.
It makes life miserable for sufferers such as Tom, 41, an engineer from York. It can also cause a condition called Barrett’s oesophagus and, in rare cases, cancer.
“It took a while to diagnose because I’ve never had heartburn – my reflux is called ‘silent’ because it affects my throat, not chest,” Tom says.
“My dentist finally spotted it because the enamel on my teeth was very damaged from the acid.”
According to Nick Boyle, consultant upper gastrointestinal surgeon at King Edward VII’s Hospital in London, refluxing a few times every day is normal, but it becomes problematic when it is more persistent or the volume is greater than average.
“This will be influenced by lifestyle choices, like diet, smoking and weight,” he says. “Factors affecting the gastro-intestinal biome may also cause reflux, as may some medications.
“However, the most usual cause is failure of the lower oesophageal sphincter, the valve between the stomach and oesophagus.”
In a healthy digestive system, the diaphragm keeps the chest and abdomen cavities separate, with a small gap for the food pipe to pass through, called the hiatus.
When this loosens and weakens, it is unable to compress the oesophagus to stop liquids passing the opposite way and allows the stomach to move into the chest – known as a hiatus hernia.
Surgery can correct the problem for persistent sufferers diagnosed with gastro-oesophageal reflux disease or laryngopharyngeal reflux.
The standard treatment is over-thecounter medication to neutralise acid, such as Gaviscon, or prescription pills to reduce production, known as proton pump inhibitors, or PPIs. Tom tried both, with lifestyle changes, to no avail.
“I cut out everything from bread and milk to onions and tomatoes. I took probiotics and turmeric pills, and I gave up alcohol and caffeine. I tried meditation to reduce stress in case that was a factor – but I was still bulk-buying Gaviscon. It was incredibly demoralising and uncomfortable.
“I used to be in bands and loved singing, but the reflux had damaged my voice. I also worried about developing Barrett’s oesophagus.” Like an increasing number of reflux patients, Tom felt uneasy about relying on PPIs long term.
While antacids are one of most regularly used medications in the world, they have been linked to other health conditions, including bone demineralisation, heart disease and dementia. “They also seem to change the normal gastro-intestinal biome,” Tom adds.
Reluctant to resort to invasive surgery to fix the problem, he searched for other options and in July 2021 read about an innovative neuromuscular training device called IQoro. Developed in Sweden by Professor Mary Hägg, this crescentshaped piece of acrylic with a handle is placed in the mouth between the lips and teeth, delivering high intensity strength training to the 148 muscles involved in the swallowing process.
“You won’t find a doctor who doesn’t agree that the problem is one of a muscular deficiency,” says Terry Morris from IQoro.
“So why don’t you just exercise it, like you would any other muscle and fix the cause instead of just treating the symptoms?
“The key difference is that muscles like our biceps are under our so-called voluntary control. You can choose to lift weights with them.
“But the ones used in your swallow are run by your autonomic nervous system and you cannot instruct your body to squeeze the muscles around your hiatal canal.”
However, after 30 years working with patients with swallowing difficulties, Professor Hägg became convinced there was a way to trigger the part of the brain stem that controls the muscles involved in this preprogrammed function.
Mr Morris adds: “When you do your IQoro training sequence, you are stimulating the four sensory nerves in the oral cavity, for 10 seconds at a time in 30 second spurts.
“This is much more than the 10th of a second when you swallow water. That sensory stimulation triggers the motor nerves that we can’t control directly to contract and flex, and exercise it back.
“There are two stages. The first is to restore the competence in the muscle and that takes two to six months of three 30-second sessions each day.
“Then you need to hold it in check and do some sort of regular maintenance training going forward.”
The company has sold 80,000 IQoro devices to date, including 13,000 in the UK. Tom is one of these. “I paid £145 for my IQoro as I was willing to give anything a try,” he says. “It was easy to use and I could feel the muscles working but it wasn’t uncomfortable. “There wasn’t an immediate improvement but I knew it was supposed to take time.”
Tom stuck with it and noticed that the symptoms gradually became less frequent and less severe.
IQoro was approved by the National Institute for Health and Care Excellence for the treatment of hiatus hernia in March 2019 and made available on prescription from May this year, but few GPs are aware of this simple alternative to medication.
Tom is now in the maintenance phase and uses his IQoro twice a day.
“I do it after brushing my teeth,” he says. “It’s part of my daily routine, like someone would do stretches for their back or pelvic floor exercises.
“I feel much better physically but also mentally, knowing I’m not going to be waking in discomfort.
“I’ve also found my voice is less hoarse which means I’m enjoying singing again too.”
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You won’t find a doctor who doesn’t agree the problem is muscular deficiency