Treatment of reflux disease at the Sachsenhausen Clinic, Germany, Frankfurt

Causes of Reflux Disease

Reflux disease is based on the lower esophageal sphincter dysfunction on the one hand, and decreased esophageal mobility on the other. Other factors that contribute to the progress of the disease include diaphragmatic hernia, obesity, the use of certain medications, alcohol and nicotine.


Nutrition can have a significant impact on reflux disease. Some of the commonly eaten foodstuffs stimulate the production of gastric juice. For example, coffee, fatty foods and alcohol contribute to gastric acid production. In addition, nicotine and stress also increase the production of hydrochloric acid.

Diaphragmatic Hernias

A large number of people suffering from reflux disease also have a diaphragmatic hernia. In the case of a diaphragmatic hernia, part of the stomach is pushed through the opening of the diaphragm next to the esophagus to the lower part of the chest. This promotes continuous leakage of hydrochloric acid into the esophagus.

Another reason for the emergence of reflux disease is the larger angle between the natural esophageal opening in the stomach and the upper part of the stomach, the so-called stomach bottom. Typically, the inclination angle is between 50 and 60 degrees. If the inclination angle exceeds 60 degrees, there may be problems.


Most pregnant women may have symptoms of reflux disease. About 50 per cent of pregnant women have increased pressure in their abdomen, which makes it easier for hydrochloric acid to enter the esophagus. After pregnancy, the symptoms of reflux disease pass without the need for treatment.

Physical Causes

There are several organic causes of reflux disease. In particular, a narrowing of the exit of the stomach or a stomach tumour, as well as scarring of the connective tissue in the esophagus, can be causes of reflux disease and discomfort resulting from it.

If there are no erosions (damages) of the mucous membrane, an attempt is initially made to treat the heartburn by changing the lifestyle and eating habits. In case of chronic course or if the mucous membrane of the esophagus is already damaged, often medicines must be taken.

Lifestyle measures for reflux treatment

A certain way of life and diet helps to prevent discomfort. So, patients are recommended to:

  • Five to six small meals a day instead of three large ones.
  • At least three hours should be between dinner and bedtime.

On fatty food and other "acid relaxers" such as coffee, tea, chocolate, alcohol and cigarettes should be largely avoided. These not only promote the formation of stomach acid, but also reduce the tension of the sphincter ("esophageal sphincter"). If this muscle no longer closes properly, the porridge can enter the esophagus.

In order to prevent the reflux of acidic gastric contents during the night, it may be helpful to sleep with your torso up.

Since stress and hectic are often involved in the development of the disease, relaxation techniques such as autogenic training or progressive muscle relaxation can also help alleviate the symptoms.

In case of overweight a weight reduction should be sought.

Prof., Dr. Stein

Prof., Dr. Stein

Head physician

Holger Bahn

Holger Bahn

Senior physician

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