Osteopathic Manipulative Treatment for Gastro-oesophageal Reflux Disease

Inclusion Criteria: * Retrosternal burning sensation and/or regurgitation * Diagnosis of reflux with any methodology * Duration of symptoms for more than 3 months * Taking short or long-term proton pump inhibitors (as needed, treatment start date and expected end date, mg, drug name) * With or without esophagitis * With or without hiatal hernia * With or without helicobacter pylori * GERDQ questionnaire \> 8 points Exclusion Criteria: * neoplastic pathologies * patients who have undergone surgery for GERD * systemic pathologies (rheumatic, infectious conditions, feverish state, vascular alterations, endocrine diseases including diabetes, metabolic and neoplastic syndromes), * patients already undergoing manipulative therapy for reflux * patients with active gastric ulcers * congenital or acquired immune diseases * allergic state of any kind * pregnancy * use of intrauterine device * patients undergoing corticosteroid therapy * patients already subjected to manual/respiratory therapy in the last 3 months