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Treatment of Reflux Esophagitis (GERD)

Due to the difficulties associated with the organization of treatment in Turkey, Switzerland, South Korea and India, we are not currently processing requests to these regions.

If you are interested in treatment in Germany, please leave a request and our specialists will contact you as soon as possible.

 

Cost for treatment

Esophagitis diagnosis1
 from  465
Conservative treatment of Esophagitis
 from  992
Treatment of reflux esophagitis with fundoplication
 from  3834
Treatment with LINX system of reflux esophagitis
 from  23250

University Hospital Duesseldorf

8.5/10
location_onGermany, Duesseldorf

Department of Gastroenterology, Hepatology and Infectology

According to the authoritative Focus magazine, the University Hospital Duesseldorf ranks among the top Germany hospitals! The hospital is an excellent example of a combination of high-quality health care, research and teaching activities. With more than 50,000 inpatients and about 300,000 outpatients every year, the hospital is
Esophagitis diagnosis1
1992
Conservative treatment of Esophagitis
3806
Treatment of reflux esophagitis with fundoplication
12606
Treatment with LINX system of reflux esophagitis
38065

University Hospital of Ludwig Maximilian University of Munich

10/10
location_onGermany, Munich

Department of Gastroenterology and Hepatology

According to the Focus magazine, the University Hospital of Ludwig Maximilian University of Munich is regularly ranked among the best medical institutions in Germany! The hospital is the largest multidisciplinary medical facility, as well as a leading research and training center in Germany and Europe. The hospital is proud of i
Esophagitis diagnosis1
2069
Conservative treatment of Esophagitis
3732
Treatment of reflux esophagitis with fundoplication
12816
Treatment with LINX system of reflux esophagitis
37914

University Hospital Ulm

8.7/10
location_onGermany, Ulm

Department of Gastroenterology and Hepatology

The University Hospital Ulm started its activities 35 years ago and during this time it has become one of the most prestigious medical institutions in Europe. The hospital is famous for its numerous discoveries and the world-class achievements in medicine and pharmaceuticals. The medical facility has 29 specialized departments a
Esophagitis diagnosis1
1848
Conservative treatment of Esophagitis
3468
Treatment of reflux esophagitis with fundoplication
12277
Treatment with LINX system of reflux esophagitis
35905

University Hospital Frankfurt am Main

10/10
location_onGermany, Frankfurt am Main

Department of Gastroenterology, Hepatology, Pulmonology, Allergology, Endocrinology and Diabetology

According to the reputable Focus magazine, the University Hospital Frankfurt am Main ranks among the top German medical facilities! The hospital was founded in 1914 and today is a well-known German medical facility, which combines rich traditions and scientific innovations. A medical team of more than 6,500 employees cares about
Esophagitis diagnosis1
1798
Conservative treatment of Esophagitis
3298
Treatment of reflux esophagitis with fundoplication
11651
Treatment with LINX system of reflux esophagitis
33902

University Hospital Heidelberg

9.8/10
location_onGermany, Heidelberg

Department of Gastroenterology, Hepatology and Infectology

According to the Focus magazine, the University Hospital Heidelberg ranks among the top five hospitals in Germany! The hospital is one of the most advanced and reputable medical institutions not only in Germany, but throughout Europe. There are more than 43 specialized departments and 13 medical institutes, which cover all field
Esophagitis diagnosis1
0
Conservative treatment of Esophagitis
0
Treatment of reflux esophagitis with fundoplication
0
Treatment with LINX system of reflux esophagitis
0

University Hospital Bonn

9.2/10
location_onGermany, Bonn

Department of Gastroenterology, Hepatology, Nephrology, Infectology, Endocrinology and Diabetology

According to the authoritative Focus magazine, the University Hospital Bonn ranks among the top ten medical facilities in Germany! The hospital was opened on January 1, 2001, although in fact it inherits the medical facility, which operated at the Faculty of Medicine of the University of Bonn. The hospital in Germany combin
Esophagitis diagnosis1
1887
Conservative treatment of Esophagitis
3697
Treatment of reflux esophagitis with fundoplication
12794

University Hospital Würzburg

9.2/10
location_onGermany, Würzburg

Department of Gastroenterology, Hematology, Oncology, Hepatology, Infectology, Rheumatology and Clinical Immunology

According to the Focus magazine in 2019, the University Hospital Würzburg ranks among the top national German hospitals! The hospital is one of the oldest medical facilities in Germany. The centuries-old traditions of first-class treatment are combined with the very latest achievements of modern evidence-based medicine and
Esophagitis diagnosis1
1743
Conservative treatment of Esophagitis
3160
Treatment of reflux esophagitis with fundoplication
11586
Treatment with LINX system of reflux esophagitis
34072

University Hospital Carl Gustav Carus Dresden

9.1/10
location_onGermany, Dresden

Department of Gastroenterology and Hepatology

According to the prestigious Focus magazine, the University Hospital Carl Gustav Carus Dresden is among the top three hospitals in Germany! The hospital is the embodiment of the standards of modern high-quality medicine. Since the hospital positions itself as a maximum care medical facility, it represents all medical fields. The
Esophagitis diagnosis1
2166
Conservative treatment of Esophagitis
4127
Treatment of reflux esophagitis with fundoplication
14904
Treatment with LINX system of reflux esophagitis
44582

University Hospital Hamburg-Eppendorf

9.2/10
location_onGermany, Hamburg

Department of Gastroenterology, Hepatology and Infectology

According to the Focus magazine, the University Hospital Hamburg-Eppendorf ranks among the top ten hospitals in Germany! Since its foundation in 1889, the hospital has taken a leading position in the European medical arena and still occupies it until today. A highly competent medical team of more than 11,000 employees takes care
Esophagitis diagnosis1
2297
Conservative treatment of Esophagitis
4202
Treatment of reflux esophagitis with fundoplication
14613
Treatment with LINX system of reflux esophagitis
44889

Charite University Hospital Berlin

9/10
location_onGermany, Berlin

Department of Hepatology and Gastroenterology

According to the authoritative Focus magazine, the Charite University Hospital Berlin occupies the first place in the rating of the top German medical facilities! The hospital is one of the largest and leading university medical complexes in Europe. The hospital in Germany provides modern diagnostics and treatment of patients, a
Esophagitis diagnosis1
2494
Conservative treatment of Esophagitis
4777
Treatment of reflux esophagitis with fundoplication
16807
Treatment with LINX system of reflux esophagitis
50924

University Hospital RWTH Aachen

8.7/10
location_onGermany, Aachen

Department of Gastroenterology, Metabolic Disorders and Internal Intensive Care

According to the prestigious Focus magazine, the University Hospital RWTH Aachen ranks among the top German hospitals! As a maximum care university medical facility, the hospital guarantees patients first-class medical services combined with a respectful and human attitude. The hospital integrates all the modern options for the
Esophagitis diagnosis1
1961
Conservative treatment of Esophagitis
3784
Treatment of reflux esophagitis with fundoplication
12750
Treatment with LINX system of reflux esophagitis
38382

University Hospital Jena

8.9/10
location_onGermany, Jena

Department of Gastroenterology, Hepatology and Infectology

According to the prestigious Focus magazine, the University Hospital Jena regularly ranks among the top German medical facilities! The hospital has positioned itself as a multidisciplinary medical facility with a long history of more than 200 years. Since its foundation, the hospital has been constantly developing and modernizin
Esophagitis diagnosis1
1991
Conservative treatment of Esophagitis
3756
Treatment of reflux esophagitis with fundoplication
10218
Treatment with LINX system of reflux esophagitis
29337

University Hospital Halle (Saale)

9.6/10
location_onGermany, Halle

Department of Gastroenterology, Hepatology and Pulmonology

According to the prestigious Focus magazine, the University Hospital Halle (Saale) ranks among the top German medical facilities! The history of the hospital has more than 300 years, and during this time it managed to earn an excellent reputation not only in Germany, but throughout the world. The hospital positions itself as a s
Esophagitis diagnosis1
1793
Conservative treatment of Esophagitis
3418
Treatment of reflux esophagitis with fundoplication
11358
Treatment with LINX system of reflux esophagitis
33798

University Hospital Marburg UKGM

8.6/10
location_onGermany, Marburg

Department of Gastroenterology, Endocrinology, Metabolism and Clinical Infectology

The University Hospital Marburg UKGM offers patients modern diagnostics and comprehensive therapy at the international level. As a maximum care hospital, the medical facility specializes in all fields of modern medicine ranging from ophthalmology to traumatology and dentistry. The main areas of specialization of the hospital are
Esophagitis diagnosis1
1741
Conservative treatment of Esophagitis
3320
Treatment of reflux esophagitis with fundoplication
11007
Treatment with LINX system of reflux esophagitis
31651

University Hospital Rechts der Isar Munich

9.8/10
location_onGermany, Munich

Department of Gastroenterology, Hepatology, Endocrinology, Diabetology and Infectology

According to the prestigious FOCUS magazine, the University Hospital Rechts der Isar Munich ranks among the Germany's top medical institutions! Founded in 1834, the hospital combines long traditions and the very latest achievements of modern medicine. The medical facility includes 33 specialized departments, 20 interdiscipli
Esophagitis diagnosis1
1934
Conservative treatment of Esophagitis
3723
Treatment of reflux esophagitis with fundoplication
12711
Treatment with LINX system of reflux esophagitis
37930

University Hospital Muenster

9.8/10
location_onGermany, Muenster

Department of Gastroenterology, Hepatology, Endocrinology, Diabetology and Infectology

According to the Focus magazine, the University Hospital Muenster ranks among the top German hospitals! The hospital belongs to the most prestigious medical institutions in Germany. The hospital is distinguished by a high professionalism of its doctors, state-of-the-art technological equipment and the availability of the most ad
Esophagitis diagnosis1
1823
Conservative treatment of Esophagitis
3454
Treatment of reflux esophagitis with fundoplication
11329
Treatment with LINX system of reflux esophagitis
33563
| from Booking Health GmbH
Reflux esophagitis (GERD) is an esophagus injury due to retrograde movement of gastric contents into the esophagus.

The most efficient treatments are fundoplication or LINX implantation.

The cost of fundoplication starts at €3,8345, the cost of treatment with the LINX system starts at €23,250. You can find other prices on the Booking Health website.

The best hospitals in Europe are:

HospitalCity
University Hospital DuesseldorfGermany, Duesseldorf
University Hospital of Ludwig Maximilian University of MunichGermany, Munich
University Hospital UlmGermany, Ulm
University Hospital Frankfurt-am-MainGermany, Frankfurt-am-Main
University Hospital HeidelbergGermany, Heidelberg

 

Gastroesophageal reflux disease (GERD) is one of the most common diseases on the planet. It affects 10% of the population. The main manifestation is a burning sensation behind the breastbone (heartburn). Many people develop esophagitis, which is an inflammation of the lining of the esophagus. Gastroesophageal reflux disease may also cause the inflammation of other organs, such as larynx, trachea, lower respiratory tract, oral mucosa and pharynx.

The disease is usually treated with conservative methods. If medications do not help, reflux is treated surgically. Doctors abroad perform the very latest laparoscopic and endoscopic interventions, allowing patients to get rid of esophagitis once and for all, with a quick recovery period and minimal health risks.

Content

  1. Is gastroesophageal reflux dangerous
  2. Treatment principles
  3. Endoscopic treatment
  4. LINX reflux management system
  5. Other surgical options
  6. Why is it worth undergoing medical treatment abroad
  7. Treatment in Europe at an affordable price

Is gastroesophageal reflux dangerous

 

Gastroesophageal reflux is a backflow of acidic contents from the stomach into the esophagus. Normally, such backflow should not occur, since the lower esophageal sphincter performs a barrier function: it passes food from the esophagus into the stomach, but blocks its reverse movement. This sphincter is made up of muscles. Its damage, an increase in pressure in the stomach or a violation of the innervation of the sphincter with its relaxation result in reflux. Hydrochloric acid burns the lining of the esophagus. If this happens regularly, esophagitis develops.

The prevalence of gastroesophageal reflux disease is very high:

  • 44% of people suffer from heartburn at least once a month.
  • 7% of people have it every day.
  • 18% have to constantly or periodically intake drugs.

In 80% of cases, the disease is mild or moderate, but about 20% of patients develop severe esophagitis. Without treatment, it leads to complications, such as ulcers, cicatricial narrowing of the esophagus (strictures), bleeding. The prolonged disease can lead to life-threatening complications, including Barrett's esophagus (a precancerous condition) and esophageal cancer.

For the diagnosis of GERD, it is sufficient for doctors to assess the clinical symptoms. However, to clarify the diagnosis and detect signs of esophagitis, instrumental tests are used. These include gastroscopy, 24-hour pH-metry and chest X-ray.

Treatment principles

 

In most patients, GERD and esophagitis do not affect life expectancy, but significantly impair its quality. The treatment involves the use of both conservative and surgical methods.

Most patients take proton pump inhibitors for a long time. These drugs block the production of hydrochloric acid in the stomach. As a result, even if reflux persists, the contents of the stomach no longer burn the esophagus. After 1-2 months of therapy, all the symptoms of esophagitis disappear, including a burning sensation in the chest and difficulty in swallowing food.

However, conservative treatment has two main problems:

  • It is ineffective in 10% of patients.
  • For the rest, the effect persists only during the treatment period and for a short time after its completion.

Many patients take medications for years. However, after their cancellation, 50% of the symptoms return after six months, and 80% manifest themselves again after a year. In longer follow-up monitoring, the likelihood of reflux symptoms returning is 100%.

Unlike conservative therapy, surgical treatment involves eliminating the cause of reflux, and therefore provides long-term results. In the twentieth century, surgery was traumatic, often caused complications, so it was performed only in the presence of severe symptoms of esophagitis. However, over the past 20 years, many new surgical interventions have been developed. They are minimally traumatic, more effective, safe, and therefore surgical interventions can be performed even in the absence of severe complications of esophagitis, if the patient wants to get rid of symptoms and avoid the need for long-term conservative therapy.

Benefits of surgical treatment for GERD with esophagitis:

  • Cause of reflux is eliminated, so the problem of esophagitis is solved once and for all.
  • Only 14% of patients need to continue drug therapy after surgery, but the doses and frequency of drug intake are reduced.
  • Patients do not need constant monitoring to detect complications of esophagitis and prevent esophageal cancer.

Absolute indications for surgery are:

  • Precancerous disease of the esophagus (epithelial metaplasia).
  • Stenosis (narrowing) of the esophagus.
  • Chronic esophagitis.
  • Shortening of the esophagus.
  • Bleeding.

Surgical intervention is recommended for patients with complications from the respiratory system and reflecting angina pectoris (vasoconstriction of the heart and with the development of pressing pain behind the breastbone). Another argument in favor of the surgery is the lack of effectiveness of drug therapy.

Endoscopic treatment

 

Endoscopic procedures for the treatment of gastroesophageal reflux disease have obvious advantages, because manipulations on the gastrointestinal organs are performed without abdominal incisions. The instruments are inserted into the esophagus through the mouth. Doctors use two main surgical interventions:

  • Stretta procedure. It involves radiofrequency ablation of the lower esophageal sphincter. The essence of the method is the effect of radiofrequency energy on the cardiac (closest to the esophagus) stomach. The result is a thickening of the affected area and a decrease in its sensitivity. The stomach stretches less after eating. The mechanical barrier to reflux is improved. The conductive pathways of the vagus nerve are damaged, and therefore the amount of transient relaxations of the lower esophageal sphincter is reduced.
  • Transoral incisionless fundoplication. The operation was developed by R.J. Mason. The essence of the procedure is intussusception (eversion) of the junction of the stomach and esophagus to create a functional nipple valve in the lower part of the esophagus.

So far, both endoscopic procedures are not considered standard treatment methods for esophagitis and gastroesophageal reflux disease. The surgical interventions are relatively new, so their long-term effects have not been determined. However, it seems like an attractive opportunity for many patients to cure esophagitis and get rid of heartburn permanently without abdominal incisions. Several European hospitals offer endoscopic treatment options for patients with esophagitis.

LINX reflux management system

 

In 2012, the FDA approved a new device for treating GERD called LINX. The technique is used in Europe as well. It provides patients with the same results as surgery for esophagitis. In this case, the treatment is minimally traumatic, since during the operation neither the esophagus nor the stomach is damaged.

The essence of the method is that a ring consisting of titanium balls with a magnetic core is put on the lower part of the esophagus. These balls are attracted, trying to connect. However, their attraction is not strong enough to block the lower esophageal sphincter completely, so they only strengthen it.

The LINX system requires a small laparoscopic surgery for implantation. A ring of balls is put on the esophagus, like a bracelet. As a result, the sphincter works better: it completely keeps the contents of the stomach at rest, including at night. When swallowing, the balls move away from each other, and the sphincter opens. After the LINX device implantation, the possibility of belching or vomiting remains.

The patient can eat food almost immediately after the surgery. However, after 2 weeks, scar tissue forms, which can impair the function of the lower esophageal sphincter. To prevent this from happening, the patient is recommended fractional frequent meals. The patient has to eat using this mode for several weeks. After 2 weeks, swallowing discomfort may appear, but it completely disappears after a month. After 3 months, a person can eat any food, does not suffer from heartburn caused by GERD, and the risk of developing esophagitis and its complications is minimal, since gastric acid no longer enters the esophagus.

Other surgical options

 

More than 40 operations have been developed for the treatment of gastroesophageal reflux and esophagitis. Here are the main types of interventions, many of which are no longer used in developed countries, but are still used in countries with poorly developed medicine:

  • Cruraphy – suturing the crura of the diaphragm to reduce the esophageal opening of the diaphragm.
  • Gastropexy – lowering of the upper part of the stomach by suturing the upper parts of the lesser curvature to the anterior abdominal wall.
  • Esophagofundorafia – fixation of the fundus of the stomach to the esophagus.
  • Fundopexy – fixation of the fundus of the stomach to the lower surface of the diaphragm.
  • Removal of a narrowed, damaged area of ​​the esophagus with plastic gastric tube.

In the second half of the twentieth century, a Nissen fundoplication was developed. It became the basis for the treatment of GERD with esophagitis. The essence of the intervention is that the upper part of the stomach is wrapped around the esophagus, thereby forming a cuff. It strengthens the lower esophageal sphincter by stopping gastroesophageal reflux.

In 1991 T. Geagea and B.D. Dallemagne were the first to perform fundoplication laparoscopically: through short abdominal incisions and with the use of video endoscopic equipment. There were also other laparoscopic interventions for the treatment of GERD with esophagitis: strengthening of the esophagogastric junction with the round ligament of the liver, reconstruction of the angle of His, anterior valvuloplasty using the Angelchik technique. However, most surgeons still prefer fundoplication in the treatment for esophagitis, since this surgery provides the most consistent results.

The main types of laparoscopic fundoplication are:

  • 360-degree Nissen fundoplication – the fundus of the stomach is wrapped around the intra-abdominal esophagus in the form of a cuff.
  • Nissen-Rossetti fundoplication – a part of the stomach is left in the chest cavity.
  • 210-270-degree posterior partial and bilateral classic Toupet fundoplication – the upper part of the stomach is wrapped around the abdominal part of the esophagus along its posterior surface.
  • Anterior partial fundoplication using the Dor technique.

The results of different operations are comparable. In addition, laparoscopic treatment is not inferior to classical open surgical interventions in both immediate and long-term results. Therefore, most cases of GERD with esophagitis are treated in Europe using minimally invasive techniques.

This approach has the following advantages:

  • Three times less need for analgesics after surgery due to less pain.
  • Less tissue trauma, less abdominal scar, better aesthetic results.
  • Less time to spend in the hospital.
  • Lower risk of complications.
  • Person loses less blood.
  • Patient recovers faster after surgery.

On average, the results persist for 10 years in 80% of patients after surgical treatment. Doctors in Europe use advanced surgical techniques, so the efficiency exceeds 90% within 10 years.

The risk of developing complications in different hospitals ranges from 2 to 10%. To minimize your health risks, you can undergo reflux esophagitis treatment abroad. In the best hospitals in the world, mortality rates are close to zero and the risk of complications is about 2%.

Why is it worth undergoing medical treatment abroad

 

If your country has poorly developed medicine, you can undergo medical treatment abroad. European experts achieve excellent results in the fight against esophagitis and gastroesophageal reflux.

There are several reasons for you to undergo medical treatment abroad:

  • Outdated surgical techniques are not used, since they are traumatic, unsafe and provide short-term results.
  • Surgeons perform advanced surgical interventions, namely fundoplication using the Nissen, Toupet and Dor techniques. They are effective in almost all patients, and in 90% of cases, the effect lasts for at least 10 years. Most treated patients will never again suffer from the symptoms and complications of esophagitis.
  • Almost all patients undergo laparoscopic surgery for the treatment of reflux esophagitis. Minimally invasive surgery contributes to a shorter recovery period.
  • The risk of complications does not exceed 2%. It is 5 times lower than in countries with poorly developed medicine.
  • Availability of innovative treatment methods, which are even more sparing: endoscopic procedures for gastroesophageal reflux and esophagitis treatment, implantation of the LINX system.

Treatment in Europe at an affordable price

 

To undergo medical treatment in one of the European hospitals, please use the services of the Booking Health company. On our website, you can see the cost of treatment in Europe and compare prices in order to book a medical care program at a favorable price. Medical treatment in Europe will be easier and faster for you, and the cost of treatment will be lower.

You are welcome to leave your request on the Booking Health website. Our specialist will contact you and provide a free consultation on treatment in Europe. Booking Health will take care of the organization of your trip abroad. We will provide the following benefits for you:

  • We will select a hospital for medical treatment in Europe, whose doctors specialize in the treatment of esophageal diseases and achieve the best results.
  • We will take care of the problem of the language barrier and help you to establish communication with your attending physician.
  • We will reduce the waiting time for the medical care program. You will undergo treatment on the most suitable dates.
  • We will reduce the price. The cost of treatment in European hospitals will be lower due to the lack of overpricing and additional coefficients for foreign patients.
  • We will take care of all organizational issues: we will draw up documents, meet you abroad and take you to the hospital, book a hotel, provide interpreting services.
  • We will prepare a medical care program and translate medical documents. You do not have to repeat the previously performed diagnostic procedures.
  • We will help you keep in touch with the hospital after treatment in Europe.
  • We will arrange additional diagnostic examinations and treatment in a European hospital, if required.
  • We will buy medicines abroad and forward them to your native country.

The world's leading doctors will take care of your health. The Booking Health specialists will help reduce the cost of treatment, organize your trip, and you will only have to focus on restoring your health.

Authors: Dr. Vadim ZhiliukDr. Sergey Pashchenko




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