Complaints & connections · borters.ch
The closure to the stomach does not seal properly — hence the burning, and hence timing and size of meals often help more than expected.
Also known as: heartburn · GERD · gastroesophageal reflux disease
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
At the junction of gullet and stomach there is no valve in the technical sense but a ring of muscle that opens to swallow and should stay shut otherwise. Reflux means it opens too often or too long, and the acid stomach contents run back a little way. The stomach is built for its acid, the gullet is not — hence the burning. The difference between the event and the disease matters: everyone has a little reflux, especially after eating. It only becomes a disease when it regularly disturbs or leaves damage. Two misunderstandings hold on stubbornly. The first: that too much acid is the cause. Usually the amount of acid is normal and the closure is the problem — the acid is simply in the wrong place. The second: that reflux always shows as heartburn. A considerable share expresses itself differently — as an irritable cough, morning hoarseness, throat clearing, a lump in the throat, or as pressure behind the breastbone that resembles a heart problem. What almost always helps has to do with time and gravity: what is eaten, when and how much, and how long you stay upright after the last meal.
Visceral fat usually goes first when overall weight drops.
Both together cut belly fat more effectively than either alone.
Promote storage in the abdominal area.
The stomach needs that time to empty. Eating late and lying down takes gravity out of the game — the single most effective point in night-time reflux.
Not more pillows, but the bed itself raised by roughly a hand’s width. Extra pillows only bend the belly and raise the pressure.
The amount per meal works more strongly for most people than any single trigger. Which foods disturb is very personal — a two-week diary says more than any general list.
Because of how the stomach lies, on the left the junction sits higher than the contents. Small studies and much experience support it, and it costs nothing.
They relieve reliably but change nothing about the closure. A time-limited trial with a clear goal and then a tapering reduction makes sense — stopping abruptly often causes a temporary rebound that looks like a relapse.
Anything that squeezes the belly lifts the pressure above the closing force: tight clothes, heavy abdominal exercise right after eating, long spells bent forward at work.
Both directly lower the tone of the muscle ring. The effect usually shows within a few days — which makes the trial checkable.
Eat nothing in the last three hours before lying down, raise the head of the bed, stay upright or walk after eating.
Raise the head end — with a wedge under the mattress or books under the bed legs, not with a stack of pillows.
Proton pump inhibitors switch off the acid pumps of the stomach cells. The reflux then no longer hurts and the oesophagus heals — the reflux itself remains. That is why symptoms often return after stopping, and why portion size, the gap before sleep and weight keep counting alongside.
About ten to twenty in a hundred people have regular heartburn. Under acid suppression the oesophagus heals in four to eight weeks; in many the symptoms return after stopping, because the reflux itself remains.
If the feeling goes while eating, that points more to tension or reflux than to an obstruction. If food actually sticks, that is something else.
Typically after eating, lying down and bending over. It draws upwards, not sideways — which usually separates it from stomach pain.
Without nausea, without retching — it simply comes. At night it sometimes wakes you with a cough or a feeling of choking.
The silent form: it does not burn, but larynx and throat take an acid mist at night. A chronic cough with a clear chest often leads here.
The feeling stays, the food goes down without trouble. Exactly that combination speaks for irritation and against a narrowing.
If solid food sticks, if blood or black stools appear or weight falls unintentionally: these are the signs where you stop trying things and look.
Reflux can cause a tight pressure behind the breastbone. New, on exertion, with breathlessness, sweating or radiating into arm or jaw, the heart is suspected first — not the other way round.
An unnoticed bleed from the gullet shows here first. Anaemia together with reflux is a reason for the endoscopy.
Falls before the haemoglobin and is therefore the earlier hint of a silent loss of blood.
With years of acid blockers it can fall — as can vitamin B12. That belongs to the follow-up of a long-term treatment.
Its uptake needs stomach acid. Under long-term acid suppression the value is worth checking every few years.
Taken up right at the end of the small bowel and needing a helper from the stomach. If either place is affected a deficiency arises — often only after years, because the liver holds a store.
Taken up in the upper small bowel and needing stomach acid. Acid blockers, an inflamed lining and silent blood losses often come together here.
One of the fat-soluble vitamins, lost with the fat when fat digestion is disturbed. Fatty, floating stools over months are the pointer to it.
Needs vitamin D for uptake, and with disturbed fat digestion it additionally binds to fatty acids in the bowel. So bone density and bowel disease hang together more closely than assumed.
Lost in considerable amounts with lasting diarrhoea. Signs are cracked corners of the mouth, loss of taste, poor wound healing and thinning hair.
Neutralises acid for 20–30 minutes and is the oldest home remedy for it. Taken regularly over weeks it brings a lot of sodium and can harm with weak heart or kidneys — a stopgap, not a treatment.
The deglycyrrhizinated form (DGL) is the one meant — ordinary liquorice raises blood pressure and lowers potassium with longer use. Studied at 380–760 mg before meals; the evidence is old and thin.
Clearly worthwhile and well supported when deficient — vegan, older adults, certain drugs. No energy boost without a deficiency.
Clearly effective with proven deficiency, useless without. Take only with a documented deficiency — excess is harmful.
Clearly worthwhile and well studied when deficient; fewer data for the wider uses. Fat-soluble — check blood levels at high doses.
Late meals, alcohol, fat, coffee as triggers.
Smaller portions, less fat and alcohol and three hours before lying down work more than most remedies.
Often recommended for reflux and just as often poorly tolerated — it can burn an inflamed gullet.
Aloe juice is traditionally drunk for an irritated gullet; watch for additives and laxative components.