Reflux generally refers to an increased reflux of food. Either from the stomach into the esophagus or through reflux from the small intestine (upper part = duodenum) back into the stomach and back into the esophagus. Both types of reflux lead to heartburn. Obesity, tight clothing, constricting belts and pregnancy increase the pressure on the abdomen and can thus promote reflux. More frequent heartburn can indicate reflux disease. There is gastric reflux, in which acidic stomach contents (hydrochloric acid in the stomach) get into the esophagus and can thereby promote inflammation (gastro-oesophageal reflux disease (GERD). Since the stomach has 2 sphincters (upper stomach area (= lower esophageal sphincter) & lower gastric sphincter = Stomach gatekeeper (= pylorus) can flow back upward in both directions, if the muscle is "weak". If the gatekeeper does not work intact, bile can get back into the stomach and possibly also back into the esophagus. Both liquids (Gastric acid / bile acid, bile juice) can cause inflammation of the gastric mucosa or in the esophagus. Complaints can be: aching pain , nausea and vomiting of stomach contents (brownish-green colored by the bile), flatulence & a burning sensation behind the Sternum .

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If the reflux persists for a longer period of time due to the disturbance in the function of the sphincter muscles, this is usually followed by inflammation of the gastric mucosa and / or the esophagus due to gastric acid or bile. If left untreated, the inflammation can become chronic & manifest in cell changes such as Barrett's esophagus or even esophageal cancer . It is therefore important to find out the exact cause of symptoms that indicate reflux and initiate appropriate treatment.

Why is nutritional therapy important?

This depends on the type of reflux:

Nutritional therapy helps you to produce less stomach acid by choosing the right food (inhibiting hydrochloric acid production). In addition, foods can be selected that can "bind" the excess acid to themselves. On the other hand, an attempt is made to reduce reflux and ultimately avoid it entirely by structuring meals and portion sizes accordingly. By omitting "acid looseners" (= foods and drinks that produce particularly strong stomach acid), you can target acid production and avoid too much acid. How much acid is formed varies from person to person and also depends on external factors such as stress, or on the internal state of mind during mealtimes and on the food directly as well as on the beverages supplied. It is a complex interplay that requires sensitivity to discover the individual causes for greater wellbeing.

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Nutritional therapy supports you in reducing your symptoms overall and thereby positively influencing your health. An energy-adjusted wholesome diet under the supervision of a certified nutritionist can lead to your long-term success. The diet is adapted to your current weight and a jointly defined goal for weight gain / or loss.

The aim is to supply all of the fatty acids, micronutrients (vitamins and minerals) that are important to you, energy and protein in the measure that your body is optimally supplied with. For this purpose, foods that promote inflammation are specifically avoided and plenty of anti-inflammatory foods are consumed.

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Goals for therapy:

1. Weight reduction in the case of overweight / obesity reduces the pressure on the stomach

2. Raising the head end of the bed, for example with a wedge pillow

3. Early dinner: the last meal should be eaten 2-3 hours before going to bed

4. Avoid chocolate & carbonated drinks →  lead to decreased pressure of the lower esophageal sphincter and thus to increased reflux.

5. Enjoy in moderation: alcohol, coffee, caffeine, spicy foods, citrus fruits, fatty foods

If fatty foods are consumed in combination with alcohol or nicotine, the acid load in the esophagus increases.

6. Avoid individual intolerances by avoiding the appropriate foods and drinks

7. Taking proton pump inhibitors (PPIs): If the general measures to improve the symptoms are not sufficient, your doctor will prescribe medication for you.

Source: S2K guideline for gastroesophageal reflux disease 2015

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Classification of your weight - definition and classification of weight in relation to height.

Special percentile curves apply to children and adolescents; the BMI cannot simply be used here.

BMI and interpretation: BMI: body mass index. Formula: Body weight in kg : (body height in m) 2

Underweight: <18.5

Normal weight: 18.5 - 24.9

Overweight = pre-obesity: 25-29.9

Obesity grade I: 30 - 34.9

Obesity grade II: 35-39.9

Obesity grade III:> 40 = per magna

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Nutritional therapy

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• Body weight: Weight reduction is recommended if you are overweight / obese.

• Holistic therapy - do you have any comorbidities that need to be taken into account during the consultation?

• Avoid micronutrient deficiencies and mineral deficiencies & possibly counteract them with nutrient preparations

• Prevent protein deficiency

• Which nutrients do I need in which ratio?

• Get enough fiber (> 30 g / day) through natural foods, possibly fiber substitution

• Sufficient fluid: total fluid per day: 30 - 35 ml per kg body weight and day. Attention, this is not just a drinking liquid. The liquid from food (approx. 500 - 800 ml) must still be subtracted from this, so that an amount of approx. 1.3 - 2 l of drinking liquid is created.

• add valuable anti-carcinogenic (anti-cancer) secondary plant substances

• A selection of foods tailored to your needs with cooking and technical information (for breakfast, snacks, lunch, dinner)

• Do you like to eat your warm meal in the evening? I am happy to cater to your individual situation and we will create a plan on how you can implement your wholesome diet into your everyday life.

• Overall fat selection, how should it be designed?

• which oils are good for me? What should I watch out for in relation to the anti-inflammatory diet?

• How much fat spread (butter / margarine / vegetable fat) can I use and which products are recommended?

• Get enough Omgea-3 fatty acids and essential fatty acids

• How can I boost and support my metabolism with natural foods?

• Coordinate sensible meal frequency for your individual case - meal allocation

• What do I have to look out for when choosing animal foods?

• How many animal foods (e.g. meat products, milk and dairy products, cheese, fish products, eggs) are recommended?

• Define the desired weight stabilization / normalization & the estimated period for this

• what should be considered with beverages and alcoholic beverages?

• How does exercise affect your body and thus also your diet?

• Avoid blood sugar fluctuations

• Sweetening foods - sweeteners, glucose, fructose, sugar and sugar substitutes, what can I use and in what quantities? How high is the respective sweetness of the different products?

• what should be considered when baking and cooking?

• what are cheap snacks / main meals

• Eating out - what should you watch out for?

• Vacation, boat trip or hospital stay, what should be considered?

• Flatulence, bloating, diarrhea, constipation, vomiting, heartburn, loss of appetite, pain related to eating, what can I do about it?

• Daily plans as an example for practical implementation in everyday life

• Enjoyment training

• Optimizing your eating situation

• long-term maintenance of a jointly defined weight

• Strengthen the stomach and intestines with natural foods

• Additional therapy options

• Dietetic products in support of nutritional therapy

• Food supplements - under certain circumstances, a supplement can be useful

• and other topics

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Any questions? I look forward to your call or email. To contact form

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Assistance:

• KISS self-help groups

• Self-help network

• German Society for Digestive and Metabolic Diseases e. V.

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