Reflux esophagitis is a complication of gastroesophageal reflux disease (GERD), which is an inflammation of the esophagus. This condition occurs due to the constant irritation of the mucous membrane by hydrochloric acid, which is produced in the stomach. Normally, it should not enter the esophagus, since the sphincter separates it from the stomach. Nonetheless, if the sphincter is weak, the muscles or nerves do not perform their function, or the pressure in the abdominal cavity is too high, acidic gastric contents are constantly thrown into the esophageal cavity and burn its walls. This is a dangerous disease that causes ulcers, bleeding, and scarring and is also the main cause of esophageal cancer.
Content
- Conservative treatment
- Who may require surgery?
- What surgical interventions can be performed in Germany?
- Endoscopic treatment
You can keep the disease under control with the help of drugs, but only surgery can get rid of GERD once and for all. Doctors in Germany perform surgical interventions using a minimally invasive laparoscopic technique. If a patient does not have a hiatal hernia, endoscopic treatment can be performed, that is, without abdominal incisions, but through the oral cavity.
You can undergo your treatment in one of the following hospitals: University Hospital Ulm, University Hospital of Ludwig Maximilian University of Munich, or University Hospital Duesseldorf.
If you make your treatment appointment at a hospital through the Booking Health service, we will fully organize your trip. Doctors at the Booking Health company will study the results of your diagnostic tests, and recommend the best treatment method and clinic. The Booking Health managers will help you to get a visa, provide insurance, take care of your flights and accommodation, control the cost of medical services, take care of interpreting services and translate medical records from the clinic into your native language. A personal coordinator will always be in touch with you during your treatment in Germany.
Conservative treatment
Up to 90% of patients are treated with conservative methods. They take drugs from the following pharmacological groups:
- proton pump inhibitors are the main drugs for controlling GERD, which are used constantly and can eliminate the manifestations of reflux esophagitis in 1-2 months;
- histamine H2 receptor blockers are obsolete drugs that were used prior to the introduction of proton pump inhibitors (which are still used in a low level of medical development);
- antacids quickly neutralize acid and stop an attack of heartburn, but they are not suitable for a permanent control of the disease due to their short-term effect.
Doctors sometimes use drugs that protect the esophageal mucosa, and prokinetics, which are agents for stimulating gastric motility. These help if GERD develops due to functional disorders.
Who may require surgery?
Surgery can be indicated in the following cases:
- a patient develops complications of reflux esophagitis, and precancerous changes in the esophagus progress;
- conservative therapy is ineffective;
- if conservative therapy causes complications, or a patient does not want to constantly take pills because of the threat of complications (when taken for many years, proton pump inhibitors increase the risk of osteoporosis, as they disrupt bone mineralization).
A surgical intervention can also be performed at a patient's request if the patient does not want to take pills that block the production of hydrochloric acid in the stomach for life. The operation results in the strengthening of the lower esophageal sphincter. If necessary, a hiatal hernia can also be eliminated, so heartburn attacks disappear, and reflux esophagitis usually disappears forever. The surgical intervention reduces the risk of developing esophageal cancer, and a person no longer needs to constantly take medications.
What surgical interventions can be performed in Germany?
A fundoplication is the main operation to treat GERD and reflux esophagitis. Doctors wrap the top of the stomach around the esophagus to strengthen the sphincter. This surgical intervention, in its classical version, is performed through a large abdominal incision. If you are undergoing treatment of reflux esophagitis in Germany, doctors will perform a minimally invasive operation using laparoscopy, that is, through short abdominal incisions. After such operations, a rehabilitation period is minimal, and complications are very rare. Some specialized centers perform robot-assisted operations, which are even safer.
The LINKS system is an alternative method of surgical treatment, and this is more sparing. The operation can be performed even on elderly and debilitated patients with concomitant diseases. The LINX Reflux Management System consists of magnetic beads that are placed around the esophageal sphincter. They are attracted, narrowing the hole. During swallowing, these beads diverge and skip food. The implantation of this system requires a minor laparoscopic surgical procedure.
Endoscopic treatment
Over the past few years, clinics in Germany have begun to offer their patients new endoscopic treatment options for GERD. The intervention is performed without abdominal incisions, but through the oral cavity. There are two systems for endoscopic treatment approved in Europe.
Stretta can be used for radiofrequency ablation (destruction by a high temperature) of the muscles in the zone of transition of the esophagus to the stomach. This technique is safe, sparing, easily tolerated, and does not require a long-term rehabilitation, but its effectiveness is lower compared to surgery.
EsophyX is an endoscopic fundoplication method from inside the stomach. The results are not worse than when performing surgery, but there is a limitation: this procedure can be performed with a hiatal hernia of up to 2 cm. If the hernia is larger, then laparoscopic fundoplication is required.
You are welcome to use the Booking Health service to undergo your diagnostics and treatment of reflux esophagitis in Germany. You can find the prices, compare the costs of medical services in different hospitals, and make your treatment appointment at the best price. Our specialists will help you to select a medical center and organize your trip.
Authors:
The article was edited by medical experts, board certified doctors Dr. Vadim Zhiliuk and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Sources:
National Library of Medicine
Centers for Disease Control and Prevention
MedicineNet
