In many letters from my patients, a serious issue appears — often only between the lines: Reflux does not only mean physical symptoms for many patients, but a fundamentally changed way of life . A shared meal, a glass of wine, an untroubled evening — these are often replaced by restriction, constant self-monitoring, and pain. An endless odyssey In search of the cause, patients often undergo a long series of examinations: CT, MRI, X-ray ECG, stress tests, cardiac catheterizati

The upward movement of bile acids is present in many reflux patients—often in a latent and unnoticed form. Initially, bile flows from the duodenum into the stomach. If it reaches the esophagus, this is referred to as DGER (duodeno-gastro-esophageal reflux) . What happens in the body? Our digestive system consists of clearly separated functional compartments: Stomach: strongly acidic environment (pH 1–2) Duodenum: alkaline environment (pH 8–8.5) Bile plays a central role in

Many patients ask themselves: Why did I develop a diaphragmatic hernia? Was it caused by physical strain, sports, or a specific event? This region of the diaphragm represents a natural weak point in every individual, which is inherently difficult for the body to stabilize. If additional risk factors are present, the system can become unbalanced. Established risk factors pregnancy (especially multiple pregnancy or a large fetus) familial predisposition (parents, grandparents)

Stiller Reflux

Reflux does not only affect the esophagus—the lungs can also be significantly impacted.In particular, gaseous components of reflux can rise upward and enter the bronchi with each breath. The result may include coughing, increased susceptibility to infections, and recurrent respiratory problems. The lungs attempt to clear these substances through coughing—a powerful protective mechanism driven by the diaphragm. However, in cases of persistent reflux, the lungs are continuousl

Many patients experience a confusing situation:test results seem to contradict each other. One endoscopy shows a hernia, the next does not. X-rays appear normal, MRI scans as well. In the end, more questions remain than answers. Why is that? The problem: the diaphragm The diaphragm is a thin, dynamic organ that moves constantly with every breath. For this reason, no single examination can fully capture it. In addition, many organs—the heart, lungs, stomach, and esophagus—are

Dear reader, At this point I would like to point out the special connection between heart problems and reflux. A patient wrote to me: "Sometimes my heart raced as fast as a sewing machine. A very frightening feeling. There was a suspicion of a heart attack and so I was thoroughly examined in the clinic: ECG, ergometry, blood tests, ultrasound of the heart, etc. The doctors said that my heart was like that of an athlete and completely fine. Because the palpitations kept coming

If you suffer from reflux symptoms, you have likely heard the term Barrett’s esophagus . This condition has been discussed in medicine for decades, and although our understanding has evolved, some uncertainty still remains. Barrett’s esophagus was first described in the 1950s by the British surgeon Norman Barrett. Today, it refers to cellular changes in the lower esophagus caused by chronic reflux. The delicate lining of the esophagus is continuously exposed to gastric acid a

The question of the relationship between Barrett’s esophagus and cancer is of particular concern to affected patients. In the past, the risk was significantly overestimated. Today we know that—fortunately—it is much lower. Nevertheless, a connection does exist, and the individual findings are crucial: Small, isolated areas of Barrett’s esophagus are considerably less concerning than so-called long-segment Barrett’s , which extends over several centimeters or spreads circumfer

Many patients initially feel relieved when the diagnosis of “reflux disease” is finally made. But very soon, the next question arises: What happens next? In everyday medical practice, treatment often follows a simple pattern:Heartburn → acid blockers → “Next patient, please.” The rest is left to the patient. A typical course A patient wrote to me: After years of uncertainty, the diagnosis was finally established.She adjusted her diet, consistently avoided many foods, took med

Meshes were originally used in hernia surgery, i.e. in the treatment of “hernias” such as inguinal or umbilical hernias. Their purpose is to cover weak areas and stabilize the abdominal wall. Both absorbable and non-absorbable materials are used. At the level of the diaphragm, however, the situation is fundamentally different: Here, the goal is not simply to close a defect, but to restore the stability of the diaphragm. A stable diaphragm is the preposition for effective refl

The internist Wilhelm Hiss (1863–1934) was born as one of six children of the renowned anatomist and physiologist of the same name. Numerous discoveries—many of them still relevant today, particularly regarding the cardiac conduction system—are associated with his name. However, he also turned his attention to the question of reflux. He observed that, when viewed from the front and with an intact diaphragm, the stomach consistently forms an acute angle with the esophagus. Thi

Dear Patients, Recently, I once again saw a patient for removal of a LINX device. This provides an opportunity to briefly explain this magnetic anti-reflux system. The LINX system consists of a chain of small magnetic beads that attract each other and are intended to close the esophagus again after swallowing. This is designed to prevent the reflux of gastric acid. The underlying principle is similar to that of fundoplication: the esophagus is deliberately constricted to prev

What is RefluxStop™? RefluxStop™ involves implanting a plastic device roughly the size of a ping-pong ball into the upper part of the stomach.The aim is to create pressure near the esophagus to prevent reflux. In addition, the foreign body induces significant scarring between the diaphragm and stomach, intended to prevent the organs from sliding upward through a disrupted diaphragm. Is this effective? The foreign body reaction does indeed lead to pronounced scar formation. Ho