A reader asks

Stomach protection no longer helps

Precise clarification is required to detect reflux disease.

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Readers ask, experts answer on the most pressing health issues. Hannes K: "I've been suffering from severe heartburn for some time. The gastric protection no longer helps so well and food keeps coming back up from my stomach when I bend down. What can I do?"

OA Dr. Christian Pizzera, specialist in general and visceral surgery: " Heartburn and regurgitation (food flows back out of the stomach) are two of the main symptoms of reflux disease. Belching, hoarseness, a chronic cough, a sore throat or a feeling of fullness can also be signs of reflux. However, these symptoms also occur with other diseases.

In order to prove (or rule out) reflux disease, a precise diagnosis is required. In addition to a gastroscopy, the sphincter muscle between the oesophagus and stomach, oesophageal function and a 24-hour measurement of reflux (reflux of stomach contents into the oesophagus) are carried out. After the evaluation, a symptom-oriented and individualized treatment can be given.

In the case of mild symptoms or so-called "air swallowing", conservative treatment measures (medication, dietary changes, speech therapy) can lead to success. If the quality of life is severely affected by reflux, surgical treatment is often advisable.

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In this case, a so-called fundoplication operation is usually performed, in which a gastric sleeve strengthens the muscle at the transition from the oesophagus to the stomach and prevents the gastric juice from flowing back. Stomach protection should be taken for two weeks after the operation. Heavy physical work should be avoided for 6-8 weeks.