Reflux disease therapy

Reflux disease (also known as "heartburn") can be treated well in most cases. The most important strategies are medication and a change in lifestyle. In rare, severe cases, surgery can help some people.

Change your lifestyle - the best tips

  • Lose weight if you are overweight (obese). The amount and strength of the reflux depends on the pressure in the abdominal cavity. If there is a lot of fat there, this pushes the stomach acid up into the esophagus. This is why pregnant women often have reflux. The growing baby also creates more pressure in the abdomen, which causes acid to leak back into the esophagus. People of normal weight are less likely to suffer from heartburn and reflux disease than overweight people. You can reduce the symptoms by losing weight. Your heart, circulation, joints and metabolism also benefit from a few pounds less.
  • Sleep properly: Position your upper body higher than your feet when you sleep. Raise the headboard of your bed. If this is not possible, place an additional pillow or a thick blanket under your head. This prevents stomach acid from flowing back into the esophagus so easily at night. It is best to sleep on your left side. In this position, the stomach is lower than the esophagus and the stomach contents rise less easily.
  • Pay attention to your diet: Alcohol, coffee, chocolate, lots of fat, carbonated drinks or hot spices are being discussed by researchers as risk factors for heartburn. Try out which foods are good for you and which are not. It is better to leave these out. Keep a food diary to find out which foods you tolerate well.
  • Do not overload your stomach with large portions during the day and especially in the evening, but rather eat five to six small meals throughout the day.
  • Take your time to eat and don’t wolf it down under time pressure. Enjoy your meals, preferably in a relaxed atmosphere.
  • Do not bend down or lie down immediately after eating – it is better to take a digestive walk. Do not lift any heavy loads.
  • Take a break from eating before going to sleep: Don’t eat anything for about three hours before going to bed. Otherwise the stomach is very busy digesting at night.

Medication for reflux disease

Often a change in lifestyle does not bring the desired success in the treatment of reflux disease. Medication is then an additional treatment option. They alleviate the symptoms as long as you take the medication.

  • Proton pump inhibitors (proton pump inhibitors, acid inhibitors, acid blockers): They slow down the production of stomach acid by blocking a special protein. Low doses of the medication are available over the counter in pharmacies, higher doses require a prescription. Proton pump inhibitors are also suitable for long-term treatment, but in lower doses than at the start of therapy. The symptoms often improve to such an extent that you can stop taking the medication again. Proton pump inhibitors are now considered to be the drugs of first choice. However, weaning should be done gradually. Otherwise you can get a “rebound effect”. The acid blockade leads to higher levels of the acid-stimulating hormone gastrin. If the proton pump inhibitors are then abruptly discontinued, a particularly large amount of stomach acid is produced and the symptoms can return.
  • Antacids bind and neutralize stomach acid.
  • Alginate takes on the consistency of a gel in the stomach and is intended to slow down the reflux of stomach acid.
  • Prokinetics promote the emptying of the stomach contents and slow down their reflux into the esophagus.

Antacids, alginate and prokinetics do not have a very strong effect. They may help with mild heartburn or if you cannot tolerate the other medication. They are available over the counter from pharmacies or online.

Surgery for reflux disease

Sometimes medication does not help sufficiently against reflux disease or the symptoms are severe. In these cases, surgery is a treatment option for reflux disease.

Anti-reflux surgery is an option if:

  • long-term treatment is necessary,
  • the reflux of stomach contents into the esophagus is demonstrably pathologically increased,
  • the symptoms are very pronounced and the quality of life suffers,
  • the symptoms are proven to be caused by reflux

However, surgery for reflux carries the risk of subsequent complications such as problems with burping, difficulty swallowing, bloating or diarrhea. Therefore, surgery is only an option in individual cases.

For patients

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University Hospital Zurich
Department of Gastroenterology and Hepatology
Rämistrasse 100
8091 Zurich

Tel. +41 44 255 85 48
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