Interdisciplinary Competence Centre for Reflux Disease
Up to 20% of the population occasionally suffers from heartburn. If the complaints occur with a
frequency that substantially affects the well-being or organ complications are expected, we talk
about the “reflux disease”. The reflux disease is usually caused by an unnatural acid load of the
lower section of the oesophagus due to the disturbed valvular mechanism at the transition from the
oesophagus to the stomach.
The clinical picture of the reflux disease is diversified. In addition to the classical
symptoms such as heartburn and pain behind the sternum, so-called extra-oesophageal complaints,
such as cough at night with expectoration in the morning, chronic asthma, hoarseness, gingival
diseases or middle ear inflammations may occur as the consequences of the reflux disease. In case
of persistent or recurrent complaints, there is the risk of degeneration of the chronically
irritated oesophagus cells. As a result, oesophageal cancer may develop. This disease is of
increasing frequency. The general lifestyle is held responsible for this.
Due to the wide-ranging symptoms, the patients initially consult different fields of
medicines. We have combined these disciplines in one competence centre under the direction of Prof.
Dr. Böttger, chief physician at the Clinic for General, Visceral and Vascular Surgery, Dr.
Schönekäs, gastro-enterologist, Prof. Dr. Wolf, ENT specialist, Dr. Eisenkolb, radiologist and Dr.
Grummt, dental surgeon.
By establishing an Interdisciplinary Reflux Centre, the EuromedClinic has set itself the goal
to be the competent contact person for patients suffering from the reflux disease. We would be glad
if you get in touch with us.
Diagnostics:
In most of the cases, the reflux disease can be diagnosed by means of the
high-resolution video endoscopy, displaying the typical damage of the mucous membrane. In many
patients it is additionally necessary to take samples (biopsies) from the transition area between
the oesophagus and the stomach, so that alterations of the oesophageal mucosa can be excluded with
certainty.
Endoscopic image of an ulcerated reflux oesophagus
If the endoscopy yields no certain results, a so-called ph-measurement can additionally be
carried out. During this examination, a small ph-measuring probe is fixed in the oesophageal region
and the acid content in the oesophagus measured wirelessly over 24 hours under everyday conditions.
By combining both methods, the diagnosis of reflux disease can nowadays be conformed in nearly all
patients with reflux complaints.
In few patients, the complaints are caused by a disorder of the oesophageal movements
(motility disorder). In this case, the oesophageal movements need to be measured (manometry).
The interdisciplinary competence team creates an individual consulting and treatment concept
out of the examination results and the symptoms indicated.
Conservative treatment:
The change of everyday habits (elevated position of the upper body, especially
following the meals and at night, losing weight in case of overweight, avoidance of
reflux-favouring food and beverages, abstention from nicotine and constrictive clothes) is one
possible conservative treatment method, which, however, usually has only limited success. The
pharmacological treatment for the reduction of the acid content in the stomach by means of
so-called proton pump inhibitors (PPI) is nowadays a very successful heartburn treatment concept.
Its disadvantage is that some patients need permanent, lifelong medication; otherwise the
complaints reoccur, while the reflux still persists. Therefore, medication shows only moderate
success in treating extra-oesophageal complaints.
Surgical treatment:
The only causal treatment method is a surgery. During this procedure, the
diaphragmatic hernia and the valvular mechanism between the oesophagus and the stomach are
restored. Nowadays, the therapeutic method is usually ensured by the so-called minimally invasive
technique (laparoscopic method). Complications occur extremely rarely. More than 90% of the
patients fully recover after the treatment. The experience of the surgeon is of essential
importance for the therapeutic success.
270-degree Toupet fundoplication
Status post surgery (4 X 0.5cm – 1cm incisions), old scars after cholecystectomy and
appendicectomy have been marked
Contact
Phone +49 911 9714-683
