When we eat, food from the mouth passes through the esophagus and the lower esophageal sphincter (or LES) opens so that it can reach the stomach. The LES can also open in the event of vomiting and belching, but its job is to retain the gastric contents in the stomach so that the acids produced for digestion do not go to corrode the esophagus.

If the LES loses its tone and begins to open even when it shouldn’t, you have all the typical symptoms of reflux. If this happens regularly, this condition becomes pathological and is called GERD (Gastroesophageal Reflux Disease).

Cardias: anatomical region of junction between the esophagus and stomach
LES (or SIX, lower esophageal sphincter): sphincter that separates the stomach from the esophagus, is located in the anatomical region of the Cardias

NO DRUGS can cure reflux, because no drug can affect the muscle tone of the LES.

The drugs serve to contain the symptoms and protect the esophagus from the erosion of gastric juices only during the period of their intake. Upon discontinuation of drug therapy, all symptoms will recur.

“Gastroesophageal reflux disease is (or should be) caused by the reflux of stomach contents into the esophagus. I emphasize the “should” because the absence of signs of inflammation of the viscera at gastroscopy is frequent, as well as the non-correlation between reflux and symptoms complained of at the 24-hour pH-impedance check.
In the classic form, the typical cause of gastroesophageal reflux is the decrease in the tone of the lower esophageal sphincter, that is, the valve that separates the esophagus from the stomach.

It is also important to point out the greater frequency of the so-called atypical forms, which include disorders related to gastro-oesophageal reflux, but occur in other organs and districts such as the upper respiratory tract, the ear, the nose, the throat, lungs, heart, nervous system and not in the stomach, esophagus or digestive system.

Furthermore, the presence of symptoms is not always associated with evidence of anatomical damage, which can be documented with gastroscopy.
The so-called NERD (Non Erosive Reflux Disease) is an example of this, as it is characterized by the presence of typical symptoms of reflux (retrosternal heartburn, regurgitation), in the absence of esophageal mucosal damage (erosions, ulcers) visible on endoscopy. This condition accounts for 60-70% of cases of gastroesophageal reflux disease (GERD).
NERD, if not even the 24-hour pH-impedancemetry shows a correspondence between reflux and symptoms, can be included among the functional intestinal diseases, that is, those increasingly frequent pathologies not supported by a defect that can be documented in diagnostic investigations.”

Dr. Prof. Antonio Iannetti
Gastroenterologist Digestive endoscopist specialized in Gastroenterology, Liver disease and Internal Medicine.
Professor of Gastroenterology at the Sapienza University of Rome.

The Lower Esophageal Sphincter (used to retain gastric contents in the stomach),
it is composed of muscle fibers.
Speaking of muscle fibers, as such they should be treated with
proven scientific techniques
to be able to return to their efficiency and thus heal reflux.

First steps to take if you suspect a GERD problem

Given the variety of symptoms, it is quite common to confuse a reflux problem with other conditions.
Delays in diagnosis are very frequent, so it is very important to talk to your doctor, request a visit to the gastroenterologist and have a correct diagnosis, perhaps carried out through a gastroscopy. While waiting for the results of the exam, reduce or stop the intake of more acidic foods depending on the severity of your symptoms.

Alcuni sintomi del reflusso gastroesofageo

  • Sour taste in the mouth;
  • Asthma;
  • Pain in the sternum;
  • Tachycardia and chest pains;
  • Sore throat;
  • Tinnitus;
  • Feeling of a lump in the throat and difficulty in swallowing (esophageal bolus);
  • Cough and mucus;
  • Awakenings at night with cough;
  • Hypersalivation;
  • Bad digestion
  • Abdominal pain

Symptoms: how to recognize a gastroesophageal reflux problem or the presence of a hiatal hernia

Chest pains, tachycardia, anxiety

Those who suffer from these symptoms show, under radioscopic examination, the ascent of the left hemidiaphragm due to the effect of aerogastria (air in the stomach) but also of aeroocolia (air in the colon).
Each form of aerogastria influences the heart rhythm, often giving rise to a diaphragm-related distress syndrome (frenospasm, H. Jarricot). In some cases, the anguish can increase to the point of generating panic attacks. Acute crises often occur at the end of a meal, especially after the ingestion of carbonated drinks. The disorder can be associated with nocturnal cough, impaired concentration and hypoglycemia, with exhaustion and sleepiness in the morning. Even if the subject tries to get better with the management of anxiety, if the problem is not solved on a physical level, the physical anguish persists.

Poor digestion, abdominal pain, colic, constipation

Poor digestion, abdominal pain, colic, constipation
The shortening of the diaphragm causes constant pressure on all underlying organs and on the inferior vena cava (WHICH PASSES INSIDE THE DIAPHRAGM).
This will result in a series of ripple effects:

  • stomach evacuating fibers fail to work well;
  • there is therefore a slow emptying of the stomach with prolongation of the time necessary for digestion;
  • slow emptying leads to fermentation of the food which contributes to the formation of the so-called “gastric bubble”;

The shortened diaphragm “chokes” the inferior vena cava causing an abdominal circulatory stasis.

Aerophagia and reflux

In light of the above, in case of slow digestion, constipation and imbalances in the intestinal bacterial flora, the typical sensation of a swollen belly may be felt, as well as the air in the stomach (aerogastria), which will be one of the stimulating factors opening of the cardia, and therefore to the onset of an open cardia with consequent gastroesophageal reflux.

Dysbiosis and S.I.B.O.: we are talking about the inferior vena cava and abdominal circulatory stasis

The inferior vena cava collects blood full of carbon dioxide and waste (therefore toxins) collected in the passage through the organs. When the diaphragm shortens, it tightens this vein that is in its muscular belly. In this way the toxins can no longer be expelled as quickly as is normal, and this over time causes stasis on the spot and consequent chronic inflammation. In practice, it hinders the venous drainage of the stomach and esophagus, causing a functional alteration first, and then organic over time, of the various abdominal viscera such as the liver, pancreas, stomach and intestines (small and colon).

When these organs fail, the consequences are:

  1. The liver has difficulty in producing sufficient bile to metabolize the fats consumed in the diet, so poorly digested fats will arrive in the small intestine and colon;
  2. the suffering pancreas will produce fewer digestive enzymes, therefore less lipase that is used to absorb fat, less amylase, trypsin, chymotrypsin, elastase, phospholipase and pancreatic nuclease, which are enzymes that are used to absorb proteins. This pancreatic enzymatic deficiency can manifest itself with a difficulty in digesting proteins and fats, and this entails an arrival, in the small intestine and in the colon, of poorly digested proteins and fats;
  3. A blood stasis in the stomach can manifest itself with an alteration of the acid secretion, of HCL hydrochloric acid, and therefore also here we will have a poorly formed chyme which may be one of the factors that prevent a good digestion of food, as well as an altered action of the muscle fibers of the stomach with evacuating function, due to this constant hyperpressure of the diaphragm on the stomach, thus giving rise to a very slow digestion due to difficulty in emptying

All these factors contribute to getting poorly digested foods (proteins, carbohydrates and fats) to the intestine. The presence of poorly digested food predisposes to the onset of bacteria or yeasts or parasites, because they serve in some way to further digest poorly digested food, thus setting in motion the fermentative or putrefactive dysbiosis or S.I.B.O.
When this alteration essentially occurs in the colon, it is referred to as dysbiosis. When it occurs in the small intestine and is accompanied by a particularly consistent bacterial growth, we speak of S.I.B.O.
Fermentative dysbiosis occurs when there is an excess of fiber and sugar in the diet, while putrefactive dysbiosis occurs when there is an excess of protein. During fermentation dysbiosis, there is the production of carbon dioxide (which is a gas and which therefore swells the belly, causing aerocolia or gastrocolia) and ethanol, that is, alcohol. In the presence of circulatory stasis, the liver has more difficulty in cleaning the blood loaded with ethanol that arrives from the intestine, therefore it is altered. This is why today many forms of fatty liver are frequently found in ultrasound even in abstainers!


Mucus can also represent the route of expulsion of toxins when the venous drainage of the entire digestive system is defective. The colon is closely related to the lungs: if the colon fails to throw out toxins, they are diverted either into the skin or into the lungs. The mucus therefore represents a way of expelling toxins.
In many cases of dermatitis, when treated with cortisone, the skin improves but then asthma often appears, precisely because the toxins are “vicarious” from the skin to the lungs. Clearly, in cases of acute asthma, there is obviously a need for cortisone as a lifesaver, the problem is for those who only do that for months or years. Acting in this way rather than solving the primary problem, that is, helping the body get rid of toxins, can only produce side effects.

The hiatal hernia

There are three types of hiatal hernia, paraesophageal, sliding (the most frequent) and mixed. In the sliding hernia, the diaphragm shortened and began to press on the stomach to such an extent that, being attached to the esophagus, it rose up through the esophageal hiatus forming the hernia. Pain in the pit of the stomach is very common with this pathology.

“I agree with Dr. Trabucco in recommending to patients suffering from gastric reflux to evaluate all the therapeutic possibilities. Modern science offers many solutions to functional digestive diseases. It is important to contact a Gastroenterologist Specialist and follow a proper diagnostic path to exclude more serious pathologies. In addition to drug treatment, for gastroesophageal reflux disease, we must remember the surgical and endoscopic therapies. The treatment method of Dr. Trabucco finds its space in supporting and, sometimes, in replacing those mentioned above.”

Dr. Prof. Antonio Iannetti
Gastroenterologist Digestive endoscopist specialized in Gastroenterology, Liver disease and Internal Medicine.
Professor of Gastroenterology at the Sapienza University of Rome.

What to do if GERD (Gastroesophageal Reflux Disease) or a hiatal hernia is diagnosed

Symptomatic treatments

The first thing to do is to protect the esophagus from the rise of the acids present in the stomach to avoid further complications. In fact, in the long run, reflux could lead to a tumor of the esophagus.

The gastroenterologist can therefore propose the use of gastric protectors, drugs capable of reducing the acid secretion produced by the stomach. Unfortunately, these drugs cannot act on the cause of the problem, that is, the tightness of the lower esophageal sphincter or the cardia. In fact, once the drugs are stopped, the problem will recur, requiring continuous cycles of therapy.

Permanently cure gastroesophageal reflux and related diseases


In severe cases, the doctor may suggest surgery, but not all patients respond in the same way and unfortunately some continue to have symptoms of the disease.

Trabucco Method Integrated Protocol

Healing means first of all understanding why reflux has appeared in your case and then acting on all the problems encountered.

Reflux is not only a pathology of the esophagus but often the esophageal disorder is only the indicator of the loss of immune neuro-endocrine balance and which can also involve other organs. So in most cases, if you want to achieve an improvement and resolution of the esophageal disorder, it is necessary to treat the altered mechanics of the gastroesophageal system, dysbiosis, acidosis, visceral fat, acid secretion of the stomach and less important is the regulation of the vegetative nervous system. The TRABUCCO Integrated Method represents an optimal solution to reflux disease and NERD thanks to the synergy between physiotherapy and systemic treatment.

Foods not recommended:

  • Tea and coffee;
  • Tomato;
  • Mint;
  • Basil;
  • Chocolate;
  • Breadcrumbs (prefer crust or rusks);
  • Alcoholic;
  • Fried;
  • Sausages;

Follow a diet based on light and easily digestible foods. As cooking methods prefer boiling or steaming.