Gastroesophageal Reflux Disease: Therapy

In infants, parent counseling is usually sufficient for physiologic gastroesophageal reflux (GÖR). The following recommendations pertain to children/adults unless otherwise indicated.

General measures

  • Nicotine restriction (refraining from tobacco use).
  • Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day); reflux symptoms are triggered in particular by acidic white wines and high-proof drinks, if necessary also alcohol restriction (abstaining from alcohol).
  • Limited caffeine consumption (max. 240 mg of caffeine per day; this corresponds to 2 to 3 cups of coffee – as far as you tolerate coffee or prefer low-acid or caffeine-free varieties – or 4 to 6 cups of green / black tea – this is usually better tolerated) [avoid bean coffee (also decaffeinated) bes. empty stomach].
  • Avoid CO2-containing drinks
  • Chew gum without peppermint and without sugar 30 minutes after a meal – this can reduce the risk of heartburn. The reason is that chewing gum seems to wash stomach acid out of the esophagus by swallowing down the saliva that forms.
  • Aim for normal weight!
    • Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program.
  • Review of permanent medication due topossible effect on the existing disease.
  • Avoidance of psychosocial stress:
    • Stress
  • Notes on sleep:
    • Avoid lying down immediately after eating. When lying down, the stomach contents flow back into the esophagus more easily.
    • If necessary, sleep with the head slightly elevated (put pillow, wedge under mattress or better under the head of the bed stones or blocks 10-15 cm high).
    • Become a “left sleeper” and sleep preferably on the left side of the body. In the left position, your stomach and its contents – relative to the ground – is lower than the esophagus. The acidic gastric juice then flows due to gravity less often into the esophagus (reflux) and thus triggers heartburn less often.
    • Tight-fitting pajamas can increase the pressure on the stomach and thus the risk of heartburn.

Conventional non-surgical therapy methods

  • Per esophago-gastro-duodenoscopy (ÖGD) from intraluminal (“inside the cavity”): sphincter augmentation (support of sphincter function) by stapling the gastric fundus near the esophagus together’
    • To the cardia (GERDX).
    • Distal esophagus/esophagus (EsophyX).
    • Through solid wall sutures or staple suture procedures (MUSE).

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
    • A total of 5 servings of fresh vegetables and fruit daily (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
  • Observance of the following special dietary recommendations:
    • For infants: Food thickening, but this only reduces visible regurgitation (reflux of food pulp from the stomach via the esophagus into the mouth) and reflux riser height. The following recommendations are for children/adults.
    • Vegetable, Mediterranean diet
    • Drinking alkaline water
    • Prefer cooked food instead of fried/fried food.
    • Avoiding very cold foods and drinks, because they reduce the movement of the esophagus.
    • Avoid voluminous meals, better to eat 4-6 small meals throughout the day.
    • Avoid late meals. Between the last meal in the evening and going to bed should be at least 3 hours.
    • Generally 2-3 hours after any meal do not lie down.
    • Avoid the following foods:
      • High-fat foods (fatty meats, lard, mayonnaise; fried foods).
      • Citrus fruits; acidic fruits, acidic juices.
      • Fruit juices, such as citrus juices and orange juice, as well as tomato juice (contain many fruit acids).
      • Sweets (esp. chocolate)
      • hypertonic (high carbohydrate) drinks such as sodas, cola drinks, cocoa.
      • Strongly carbonated mineral water
      • Peppermint tea and peppermint lozenges
      • Pickled vegetables, tomato ketchup
      • Garlic and onions
      • Hot spices
    • Diet rich in:
      • Minerals (calcium, magnesium)
  • Selection of appropriate food based on the nutritional analysis
  • See also under “Therapy with micronutrients (vital substances)” – Taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Sports Medicine

  • Avoid strenuous physical activity such as bicycle ergometer training before going to bed.
  • For detailed information on sports medicine, please contact us.

Psychotherapy