Reflux disease
Reflux diseases (“Heartburn” and “reflux”)
Heartburn/acid regurgitation frequently occurs because of increased reflux of acidic gastric juice into the oesophagus. The culprit is often a hernia (so-called “hiatus hernia”). The formation of a diaphragm rupture is, among other factors, promoted by obesity, but there is also a hereditary component. Heartburn can also result from poor nutrition and other specific factors such as smoking (nicotine) and stress.
Symptoms/Problems
In principle, a complete resolution of symptoms can be achieved. Most complaints can, in addition to the typical acidic belching and burning sensation in the throat and stomach, include flatulence, changes in the sense of taste etc. Consider our questionnaire to this topic in the download section.
Clarification
A hiatus hernia or other changes (i.e. gastric ulcer, gastritis, gastric polyps, gastric cancer, celiac disease, infections, indications for allergic diseases and others) may exist. In about half of all examinations, a normal result can present itself and then "non-erosive reflux disease" is presumed. If the cause of symptoms is unclear in some cases, further clarification can be undertaken using manometry (pressure measurement) and/or acid measurement methods in our practice.
Therapy
Lifestyle adjustments
Adjustments made to one’s lifestyle are the first and most important measures. General measures that are helpful in reducing heartburn/reflux are:
- discontinuation of smoking: nicotine is the strongest factor causing reflux!
- not eating too late in the evening and walking after dinner
- sleeping in an inclined bed so that the upper body is positioned higher than the legs
- overweight status: weight loss
- loose clothing (not too tight pants and belt fitted loosely)
Nutrition
Nutritional factors that can promote heartburn/reflux should be avoided. Individual intolerances should be taken into consideration! Although there are no strict diet recommendations associated with reflux diseases, there are some general nutritional principles which include:
- avoiding sugars and sugary foods
- avoiding fats and fatty foods
- avoiding hard to digest foods (often based on an individual’s tolerance)
- spreading several small meals throughout the day
Nutritional factors that can promote heartburn/reflux should be avoided. Individual intolerances should be taken into consideration! Although there are no strict diet recommendations associated with reflux diseases, there are some general nutritional principles which include:
- avoiding sugars and sugary foods
- avoiding fats and fatty foods
- avoiding hard to digest foods (often based on an individual’s tolerance)
- spreading several small meals throughout the day
Consumption of the following foods can trigger symptoms and should be avoided based on individual tolerance:
- acid-rich foods such as tomatoes, tomato sauce, ketchup, citrus fruits/juices
- strongly heated breaded and deep-fried fats
- full cream (heated) cheese, mayonnaise, fatty meat and fish products
- hot spices and sauces, cabbage, cucumbers, peppers, onions and garlic
- pickled vegetables, vinegar in large quantities, sour, unripe fruit and their juices
- cacao, chocolate, (in general) sweets and ice creams
- coffee in general, black tea, cola and energy drinks
- alcohol, sweetened mineral water, carbonated mineral water (especially with an empty stomach)
- bouillon broth and possibly also raw food (salad/fruit), cereals/whole grains in general
Medication
Acid-binding drugs such as “Rennie”, Alucol, Riopan etc (as lozenges or gels): these directly bind acid and immediately result in a decrease in heartburn and its symptoms. The effect, however, does not last very long. Regular intake of so-called proton pump inhibitors (acid blockers) in tablet form such as omeprazole, pantoprazole, esomeprazole, lansoprazole, rabeprazole (prescribed by your doctor) can lead to an approx. 24-hour continuous acid blocking action in the stomach. They should be used when heartburn persists beyond the effect of general acid-binding drugs.
Surgery
In some severe cases, particularly when the above mentioned measures do not achieve some relief, there is the possibility of surgical treatment (e.g. fundoplication [anti-reflux surgery]). We can organize this therapy with our network of surgical partners.