As gastroesophageal Reflux (GERD) a backflow of stomach contents into the esophagus. GERD (gastro esophageal reflux disease) is the most common disease of the upper gastrointestinal tract, with>40% of the normal population suffering from reflux with heartburn as the main symptom.

The quality of life of reflux patients is often significantly impaired by excruciating heartburn, (acidic) belching, bad breath, etc. So far, the disease has often been underestimated per se and also with regard to the potential oncological complication.

Excessive and /or abnormally long contact of the esophageal mucosa with gastric juice and bile acids leads to damage to the esophageal mucosa and also to the esophageal muscles. If left untreated, reflux (GERD) can lead to inflammation and ulcers of the esophagus (esophagitis) or even constrictions (stenoses) due to inflammatory and scarred changes. If reflux GERD has existed for a long time, a precancerous stage, a so-called Barrett's, can develop in the damaged area after many years. Barrett's epithelium is a change in the mucous membrane that is triggered by the cumulative local action of highly aggressive substances such as gastric acid and bile salts.

The incidence of adenocarcinoma of the esophagus in Europe has increased 3-4 times over the last 10 years and almost all adenocarcinomas are caused by Barrett's esophagitis. So there is a causal relationship between reflux (GERD) and esophageal cancer , with reflux being the strongest known risk factor for esophageal cancer . In a 2005 study the clear connection between reflux, Barrett's and a resulting higher mortality compared to the normal population was worked out. For this reason, early detection and adequate treatment of reflux disease is very important!

Causes of reflux - GERD can be a dysfunctional, structurally defective, incompetent lower esophageal sphincter - mostly based on a hiatal hernia (diaphragmatic hernia) -, a primary disturbance in the movement of the esophagus or a disturbed gastric emptying, among the most important causes call. Transient oesophageal sphincter relaxation (= spontaneous opening of the lower occlusive apparatus of the esophagus) can also play an important role in GERD.

According to new studies, up to 40% of transient relaxations are responsible for reflux disease. Structurally defective sphincters were also found in patients with reflux, both with and without a hiatal hernia. The function and strength of the right diaphragmatic leg are also decisive for the competence of the hiatus. For a competent occlusion device to prevent pathological reflux, a functioning and intact high pressure zone in the esophagus and at the same time an intact, functioning diaphragm with strong diaphragmatic thighs are necessary.

Press article

Further information