What are the main causes of GERD. How is GERD diagnosed. What are the most effective treatments for managing GERD symptoms. Can lifestyle changes help relieve GERD. When should you see a doctor about GERD symptoms. What complications can occur if GERD is left untreated. How can GERD impact sleep and daily life.

Understanding Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease, commonly known as GERD, is a chronic digestive disorder that affects millions of people worldwide. It occurs when stomach acid frequently flows back into the esophagus, causing irritation and discomfort. The most common symptom of GERD is heartburn, a burning sensation in the chest that can extend to the throat.

GERD is a widespread condition, with approximately one-third of Americans experiencing heartburn at least once a month. More alarmingly, 10% of individuals suffer from heartburn nearly every day. The impact of GERD on daily life is significant, with 75% of nighttime heartburn sufferers reporting sleep disturbances and 40% noting decreased job performance the following day.

Common Symptoms and Triggers of GERD

GERD manifests through various symptoms, with heartburn being the most prevalent. Other common symptoms include:

• Regurgitation of food or sour liquid
• Difficulty swallowing (dysphagia)
• Chest pain
• Chronic cough
• Hoarseness
• Sensation of a lump in the throat

Several factors can trigger or exacerbate GERD symptoms:

• Consuming spicy, fatty, or acidic foods
• Eating large meals
• Lying down shortly after eating
• Pregnancy
• Obesity
• Smoking
• Certain medications

Diagnosing GERD: When to Seek Medical Attention

While many individuals manage GERD symptoms through lifestyle changes and over-the-counter medications, persistent or severe symptoms warrant medical attention. Healthcare providers typically diagnose GERD based on a patient’s description of symptoms and medical history.

During a consultation, a doctor may ask questions such as:

• Do your symptoms worsen after eating certain foods?
• Does bending over or lying down aggravate your symptoms?
• Are your symptoms linked to stress or anxiety?
• Do you experience non-burning chest pain, difficulty swallowing, or persistent coughing?

In some cases, further diagnostic tests may be necessary to confirm GERD or rule out other conditions. These tests may include:

• Upper endoscopy
• Esophageal pH monitoring
• Esophageal manometry
• Barium swallow radiograph

Treatment Options for Managing GERD

The treatment of GERD typically involves a combination of lifestyle modifications and medications. The goal is to reduce acid reflux, alleviate symptoms, and prevent complications.

Lifestyle Changes

Simple lifestyle modifications can often provide significant relief from GERD symptoms:

• Maintaining a healthy weight
• Avoiding trigger foods
• Eating smaller meals
• Avoiding lying down immediately after eating
• Elevating the head of the bed
• Quitting smoking
• Limiting alcohol consumption

Medications

Several types of medications can help manage GERD symptoms:

1. Antacids: Provide quick relief by neutralizing stomach acid
2. H2 receptor blockers: Reduce acid production
3. Proton pump inhibitors (PPIs): Offer stronger and longer-lasting reduction of stomach acid
4. Prokinetics: Strengthen the lower esophageal sphincter and help the stomach empty faster

For typical reflux symptoms, doctors often start treatment with a proton pump inhibitor (PPI) such as omeprazole or lansoprazole. If symptoms improve, this confirms the diagnosis of GERD. Depending on the response, patients may continue with the PPI or switch to a less potent medication like an H2 blocker or antacid.

The Impact of GERD on Sleep and Daily Life

GERD can significantly affect an individual’s quality of life, particularly when symptoms occur at night. Nighttime heartburn can disrupt sleep patterns, leading to fatigue and decreased productivity during the day. A survey revealed that 65% of people with heartburn experience symptoms both during the day and at night, with 75% of nighttime heartburn sufferers reporting sleep disturbances.

The impact of GERD extends beyond physical discomfort. Chronic symptoms can lead to anxiety, social isolation, and reduced overall well-being. Managing GERD effectively is crucial not only for symptom relief but also for maintaining a good quality of life.

GERD and Respiratory Symptoms: An Often Overlooked Connection

GERD can sometimes manifest through respiratory symptoms, which may be mistaken for other conditions. These symptoms can include:

• Asthmatic wheezing
• Chronic coughing
• Hoarseness

When these symptoms occur in adult non-smokers with no history of lung disease, asthma, or allergies, GERD may be the underlying cause. Recognizing this connection is important for proper diagnosis and treatment.

Complications of Untreated GERD

While GERD is often manageable with appropriate treatment, leaving it untreated can lead to serious complications:

• Esophagitis: Inflammation of the esophagus
• Esophageal stricture: Narrowing of the esophagus due to scar tissue
• Barrett’s esophagus: Changes in the esophageal lining that increase the risk of esophageal cancer
• Esophageal cancer: A rare but serious potential complication of long-term GERD
• Dental problems: Erosion of tooth enamel due to frequent acid exposure

Regular follow-ups with a healthcare provider and adherence to treatment plans can help prevent these complications and ensure optimal management of GERD.

GERD in Special Populations: Pregnancy and Infants

GERD can affect individuals at various life stages, with some populations being more susceptible to its effects.

GERD During Pregnancy

Many women experience heartburn and GERD symptoms during pregnancy, particularly in the second and third trimesters. This is due to hormonal changes and the growing uterus putting pressure on the stomach. While most cases resolve after delivery, managing symptoms during pregnancy is important for the comfort of the mother.

GERD in Infants

Infants commonly experience reflux, often referred to as “spitting up.” While this is usually harmless and resolves as the child grows, some infants may develop GERD. Signs of GERD in infants can include:

• Frequent spitting up or vomiting
• Irritability during or after feeding
• Poor weight gain
• Difficulty sleeping
• Arching of the back during feeding

Parents should consult a pediatrician if they suspect their infant may have GERD, as proper management is crucial for the child’s growth and development.

Emerging Therapies and Research in GERD Management

As our understanding of GERD evolves, new treatment approaches are being developed and studied. Some emerging therapies include:

• Endoscopic techniques: Minimally invasive procedures to strengthen the lower esophageal sphincter
• Magnetic sphincter augmentation: A device implanted around the lower esophageal sphincter to prevent reflux
• Potassium-competitive acid blockers (P-CABs): A new class of acid-suppressing medications
• Probiotics and microbiome modulation: Exploring the role of gut bacteria in GERD

Ongoing research aims to improve our understanding of GERD’s underlying mechanisms and develop more targeted and effective treatments. Patients with persistent or severe GERD may benefit from discussing these newer options with their healthcare providers.

Dietary Strategies for Managing GERD

While individual triggers can vary, certain dietary strategies can help manage GERD symptoms:

Foods to Avoid or Limit

• Citrus fruits and juices
• Tomato-based products
• Spicy foods
• Fatty or fried foods
• Chocolate
• Mint
• Caffeine
• Alcoholic beverages

GERD-Friendly Foods

• Lean proteins
• Non-citrus fruits
• Vegetables (except tomatoes and onions)
• Whole grains
• Low-fat dairy products
• Herbal teas (non-mint)

Keeping a food diary can help identify personal trigger foods and guide dietary choices. It’s important to note that while these guidelines can be helpful, individual responses to foods can vary. Working with a registered dietitian can provide personalized dietary advice for managing GERD.

The Role of Stress Management in GERD Control

While stress doesn’t cause GERD, it can exacerbate symptoms and make them more difficult to manage. Incorporating stress-reduction techniques into daily life can complement other GERD treatments:

• Mindfulness meditation
• Deep breathing exercises
• Regular physical activity
• Yoga or tai chi
• Progressive muscle relaxation
• Cognitive-behavioral therapy

These techniques can help reduce stress-related muscle tension, promote relaxation, and potentially decrease the frequency and severity of GERD symptoms. Additionally, stress management can improve overall well-being and quality of life for individuals living with chronic conditions like GERD.

When to Consider Surgical Options for GERD

While most cases of GERD can be managed with lifestyle changes and medications, some individuals may require surgical intervention. Surgery might be considered in the following situations:

• Symptoms persist despite lifestyle changes and optimal medical therapy
• Intolerance to long-term use of medication
• Complications of GERD, such as severe esophagitis or Barrett’s esophagus
• Large hiatal hernia contributing to GERD symptoms

The most common surgical procedure for GERD is fundoplication, which involves wrapping the upper part of the stomach around the lower esophagus to reinforce the sphincter. This can be performed laparoscopically, resulting in smaller incisions and faster recovery times.

Other surgical options include:

• LINX device implantation: A ring of magnetic beads placed around the lower esophageal sphincter
• Stretta procedure: Uses radiofrequency energy to strengthen the lower esophageal sphincter
• TIF (Transoral Incisionless Fundoplication): A less invasive endoscopic procedure

The decision to pursue surgery should be made in consultation with a gastroenterologist and a surgeon, considering the individual’s specific situation, overall health, and potential risks and benefits of the procedure.

Living with GERD: Long-Term Management and Monitoring

Managing GERD is often a long-term process that requires ongoing attention and adjustment. Here are some key aspects of long-term GERD management:

Regular Follow-ups

Scheduled check-ups with a healthcare provider are essential to monitor the effectiveness of treatment and make necessary adjustments. These visits may include:

• Reviewing symptom control and medication efficacy
• Discussing any new symptoms or concerns
• Adjusting treatment plans as needed
• Scheduling follow-up tests or procedures if required

Monitoring for Complications

Long-term GERD patients should be aware of potential complications and report any concerning symptoms to their healthcare provider promptly. These may include:

• Difficulty or pain when swallowing
• Unexplained weight loss
• Persistent hoarseness or coughing
• Chest pain unrelated to heartburn

Lifestyle Maintenance

Maintaining GERD-friendly lifestyle habits is crucial for long-term symptom management:

• Consistently following dietary guidelines
• Maintaining a healthy weight
• Practicing stress management techniques
• Avoiding trigger situations (e.g., eating late at night)
• Adhering to medication schedules as prescribed

Support and Education

Living with a chronic condition like GERD can be challenging. Patients may benefit from:

• Joining support groups or online communities
• Staying informed about new research and treatment options
• Educating family members about GERD to foster understanding and support
• Working with a multidisciplinary team of healthcare providers for comprehensive care

By taking an active role in their care and maintaining open communication with healthcare providers, individuals with GERD can effectively manage their condition and maintain a good quality of life. Remember that GERD management may require periodic adjustments, and what works best can vary from person to person. Patience and persistence are key in finding the most effective long-term management strategy.

Cooling Heartburn – Harvard Health

You enjoyed the meal, but now you’re paying for it, big time. You’ve got heartburn — an uncomfortable burning sensation radiating up the middle of your chest. Heartburn, the most common gastrointestinal malady, can hit after you eat spicy foods, when you lie down to take a nap, or perhaps at bedtime. Many women experience this sensation during pregnancy. 

About one-third of Americans have heartburn at least once a month, with 10% experiencing it nearly every day. One survey revealed that 65% of people with heartburn may have symptoms both during the day and at night, with 75% of the nighttime heartburn patients saying that the problem keeps them from sleeping, and 40% reporting that nighttime heartburn affects their job performance the following day. This epidemic leads people to spend nearly $2 billion a year on over-the-counter antacids alone. Clearly, it’s a major problem.

Heartburn is an expression of a condition known as gastroesophageal reflux disease (GERD), often called “reflux,” in which acid and pepsin rise from the stomach into the esophagus, much like water bubbling into a sink from a plugged drain.

While GERD — and its symptom, heartburn — can be difficult to cope with, many people manage them quite well. However, other people spend countless hours and untold sums of money looking for a way to spell relief.

This Harvard Medical School Guide explains the causes of GERD, and what you can do to prevent and treat it.

Prepared by the editors of Harvard Health Publishing in consultation with Lawrence S. Friedman, M.D., Professor of Medicine at Harvard Medical School, Chair of the Department of Medicine at Newton-Wellesley Hospital, along with Howard E. LeWine, M.D., Assistant Professor of Medicine

Harvard Medical School. 22 pages. (2017)

Harvard Medical School Guides delivers compact, practical information on important health concerns. These publications are smaller in scope than our Special Health Reports, but they are written in the same clear, easy-to-understand language, and they provide the authoritative health advice you expect from Harvard Health Publishing.

Diagnosing GERD

Many people can manage heartburn without seeking medical care, through dietary changes, over-the-counter medications, and relaxation therapy. A doctor may be helpful if your symptoms don’t respond to self-help techniques and if they interfere with sleep or daily life.

If you do seek your physician’s advice, he or she will review your medical history and ask detailed questions about the nature of the pain and its pattern of onset. For example, your doctor may ask whether symptoms are worse after you eat a heavy meal or known dietary troublemakers such as high-fat foods or dairy products. Your doctor will want to know if bending over to tie your shoelaces or lying down aggravates the symptoms and whether the pain seems linked to anxiety or stress.

For typical reflux symptoms, doctors usually forgo diagnostic tests and proceed straight to treatment. A common starting place is a proton pump inhibitor (PPI) such as omeprazole or lansoprazole. If this provides relief, the odds are that the diagnosis of GERD was correct. Once the symptoms are under control, you may continue with the PPI or switch to a less powerful medication. That could be an h3-receptor antagonist (h3 blocker) such as cimetidine (Tagamet), ranitidine (Zantac), or famotidine (Pepcid), or an antacid.

Your doctor will be alert for other symptoms, such as frequent nonburning chest pain, bleeding into the GI tract, dysphagia (difficulty in swallowing), hoarseness, or constant coughing and wheezing. Such symptoms may be associated with GERD, but could have other causes and might warrant tests to gain more information.

GERD  sometimes causes respiratory problems such as asthmatic wheezing, coughing, or hoarseness. When these symptoms occur in adult nonsmokers with no history of lung disease, asthma, or allergies, GERD maybe the culprit.

Going Off Antidepressants – Harvard Health Publishing

Coming off your medication can cause antidepressant withdrawal – and could set you up for a relapse of depression.

Can going off your medication cause antidepressant withdrawal symptoms (antidepressant discontinuation syndrome)? About 10% of women ages 18 and over take antidepressants. As many of us know, these medications can be a godsend when depression has robbed life of its joy and made it hard to muster the energy and concentration to complete everyday tasks. But as you begin to feel better and want to move on, how long should you keep taking the pills?

If you’re doing well on antidepressants and not complaining of too many side effects, many physicians will renew the prescription indefinitely — figuring that it offers a hedge against a relapse of depression. But side effects that you may have been willing to put up with initially — sexual side effects (decreased desire and difficulty having an orgasm), headache, insomnia, drowsiness, vivid dreaming, or just not feeling like yourself — can become less acceptable over time, especially if you think you no longer need the pills.

The decision to go off antidepressants should be considered thoughtfully and made with the support of your physician or therapist to make sure you’re not stopping prematurely, risking a recurrence of depression. Once you decide to quit, you and your physician should take steps to minimize or avoid the discontinuation symptoms that can occur if such medications are withdrawn too quickly.

Why antidepressant withdrawal?

Antidepressants work by altering the levels of neurotransmitters — chemical messengers that attach to receptors on neurons (nerve cells) throughout the body and influence their activity. Neurons eventually adapt to the current level of neurotransmitters, and symptoms that range from mild to distressing may arise if the level changes too much too fast — for example, because you’ve suddenly stopped taking your antidepressant. They’re generally not medically dangerous but may be uncomfortable.

Among the newer antidepressants, those that influence the serotonin system — selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) — are associated with a number of withdrawal symptoms, often called antidepressant or SSRI discontinuation syndrome. Stopping antidepressants such as bupropion (Wellbutrin) that do not affect serotonin systems — dopamine and norepinephrine reuptake inhibitors — seems less troublesome overall, although some patients develop extreme irritability.

Having discontinuation symptoms doesn’t mean you’re addicted to your antidepressant. A person who is addicted craves the drug and often needs increasingly higher doses. Few people who take antidepressants develop a craving or feel a need to increase the dose. (Sometimes an SSRI will stop working — a phenomenon called “Prozac poop-out” — which may necessitate increasing the dose or adding another drug.)

Antidepressant withdrawal symptoms

Neurotransmitters act throughout the body, and you may experience physical as well as mental effects when you stop taking antidepressants or lower the dose too fast. Common complaints include the following:

• Digestive. You may have nausea, vomiting, cramps, diarrhea, or loss of appetite.
• Blood vessel control. You may sweat excessively, flush, or find hot weather difficult to tolerate.
• Sleep changes. You may have trouble sleeping and unusual dreams or nightmares.
• Balance. You may become dizzy or lightheaded or feel like you don’t quite have your “sea legs” when walking.
• Control of movements. You may experience tremors, restless legs, uneven gait, and difficulty coordinating speech and chewing movements.
• Unwanted feelings. You may have mood swings or feel agitated, anxious, manic, depressed, irritable, or confused — even paranoid or suicidal.
• Strange sensations. You may have pain or numbness; you may become hypersensitive to sound or sense a ringing in your ears; you may experience “brain-zaps” — a feeling that resembles an electric shock to your head — or a sensation that some people describe as “brain shivers. “

As dire as some of these symptoms may sound, you shouldn’t let them discourage you if you want to go off your antidepressant. Many of the symptoms of SSRI discontinuation syndrome can be minimized or prevented by gradually lowering, or tapering, the dose over weeks to months, sometimes substituting longer-acting drugs such as fluoxetine (Prozac) for shorter-acting medications. The antidepressants most likely to cause troublesome symptoms are those that have a short half-life — that is, they break down and leave the body quickly. (See the chart “Antidepressant drugs and their half-lives.”) Examples include venlafaxine (Effexor), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa). Extended-release versions of these drugs enter the body more slowly but leave it just as fast. Antidepressants with a longer half-life, chiefly fluoxetine, cause fewer problems on discontinuation.

Besides easing the transition, tapering the dose decreases the risk that depression will recur. In a Harvard Medical School study, nearly 400 patients (two-thirds of them women) were followed for more than a year after they stopped taking antidepressants prescribed for mood and anxiety disorders. Participants who discontinued rapidly (over one to seven days) were more likely to relapse within a few months than those who reduced the dose gradually over two or more weeks.

How to go off antidepressants

If you’re thinking about stopping antidepressants, you should go step-by-step, and consider the following:

Take your time. You may be tempted to stop taking antidepressants as soon as your symptoms ease, but depression can return if you quit too soon. Clinicians generally recommend staying on the medication for six to nine months before considering going off antidepressants. If you’ve had three or more recurrences of depression, make that at least two years.

Talk to your clinician about the benefits and risks of antidepressants in your particular situation, and work with her or him in deciding whether (and when) to stop using them. Before discontinuing, you should feel confident that you’re functioning well, that your life circumstances are stable, and that you can cope with any negative thoughts that might emerge. Don’t try to quit while you’re under stress or undergoing a significant change in your life, such as a new job or an illness.

Make a plan. Going off an antidepressant usually involves reducing your dose in increments, allowing two to six weeks between dose reductions. Your clinician can instruct you in tapering your dose and prescribe the appropriate dosage pills for making the change. The schedule will depend on which antidepressant you’re taking, how long you’ve been on it, your current dose, and any symptoms you had during previous medication changes. It’s also a good idea to keep a “mood calendar” on which you record your mood (on a scale of one to 10) on a daily basis.

Consider psychotherapy. Fewer than 20% of people on antidepressants undergo psychotherapy, although it’s often important in recovering from depression and avoiding recurrence. In a meta-analysis of controlled studies, investigators at Harvard Medical School and other universities found that people who undergo psychotherapy while discontinuing an antidepressant are less likely to have a relapse.

Stay active. Bolster your internal resources with good nutrition, stress-reduction techniques, regular sleep — and especially physical activity. Exercise has a powerful antidepressant effect. It’s been shown that people are far less likely to relapse after recovering from depression if they exercise three times a week or more. Exercise makes serotonin more available for binding to receptor sites on nerve cells, so it can compensate for changes in serotonin levels as you taper off SSRIs and other medications that target the serotonin system.

Seek support. Stay in touch with your clinician as you go through the process. Let her or him know about any physical or emotional symptoms that could be related to discontinuation. If the symptoms are mild, you’ll probably be reassured that they’re just temporary, the result of the medication clearing your system. (A short course of a non-antidepressant medication such as an antihistamine, anti-anxiety medication, or sleeping aid can sometimes ease these symptoms. ) If symptoms are severe, you might need to go back to a previous dose and reduce the levels more slowly. If you’re taking an SSRI with a short half-life, switching to a longer-acting drug, like fluoxetine, may help.

You may want to involve a relative or close friend in your planning. If people around you realize that you’re discontinuing antidepressants and may occasionally be irritable or tearful, they’ll be less likely to take it personally. A close friend or family member may also be able to recognize signs of recurring depression that you might not perceive.

Complete the taper. By the time you stop taking the medication, your dose will be tiny. (You may already have been cutting your pills in half or using a liquid formula to achieve progressively smaller doses.) Some psychiatrists prescribe a single 20-milligram tablet of fluoxetine the day after the last dose of a shorter-acting antidepressant in order to ease its final washout from the body, although this approach hasn’t been tested in a clinical trial.

Check in with your clinician one month after you’ve stopped the medication altogether. At this follow-up appointment, she or he will check to make sure discontinuation symptoms have eased and there are no signs of returning depression. Ongoing monthly check-ins may be advised.

Image: AlinaTraut/Getty Images

The greatness of Gerd Müller is in memorable photos: winning goals in the World Cup and Euro finals, a record 365 goals and 32 hat-tricks – Photo of the year – Blogs

Photo of the year

Blog

Scorer of the nation.

Gerd Müller passed away at the age of 75. One of the greatest strikers in the history of football left behind a huge number of records, some of which hold even after almost half a century.

Müller was born in November 1945 in the American occupation zone of Germany. He was the youngest of six children in the family, he left school at 15 and went to work in a factory. There was not enough money – by that time my father had already died.

Gerd devoted all his free time to football, and in 1960 he began his career at TSV 1861 from his native Bavarian town of Nördlingen. At first he played for the youth team, and at the base for the 1963/64 season he scored 47 goals in 28 matches. Now “TSV 1861” plays at the stadium named after Gerd Müller.

Germany quickly found out about the talented striker. The main club of Munich immediately knocked – this is not about Bayern, but about Munich 1860, which was then a great force. In 1963, Munich became one of the co-founders of the Bundesliga, at 1964th won the German Cup, in 1965 reached the final of the Cup Winners’ Cup, and in 1966 took the Bundesliga. But the director of Bayern, which then still played in the regional league, was ahead of the sixties and was the first to come to Gerd with a contract.

The young striker doubted that he would be able to immediately start playing at the base of the Bundesliga club, so he accepted the offer from Bayern. In addition, there was a nice bonus: Gerd got a part-time job in a Munich furniture store.

True, it didn’t work out right away even here – the coach didn’t really believe in Gerd. But over time, Muller proved management wrong. His partners at Bayern were future world football stars Franz Beckenbauer and Sepp Mayer. A season later, they reached the Bundesliga together.

Thus began the era of Gerd Müller:

• 365 goals in the Bundesliga, still the all-time high (second-placed Lewandowski has 277).

• 32 hat-tricks in the Bundesliga – still a record.

• 7 times top scorer of the Bundesliga season – a record.

• 1970 Ballon d’Or, 1970 Golden Boot, 1972.

Müller also sparkled in the national team. In 1970, he became the top scorer of the 1970 World Cup with 10 goals. The semi-final with the Italians was called by many the match of the century (5 goals in extra time), Muller put a double, but the Germans lost 3:4. From the first tournament, the forward left with bronze, but then only great victories.

Euro 1972 – and Müller is top scorer again with 4 goals, this time with a gold medal. In the final, Gerd scored a double against the USSR. The Germans won 3:0.

Two years later, Müller reached the title of world champion. In the home final against the Dutch, he again scored the winning goal (2:1).

The match was Müller’s last in the national team. At his peak, at the age of 28, he left, citing his desire to spend more time with his family.

During his 8 years with the team, Müller scored 68 goals in 62 matches. Only Miroslav Klose has more (71), but it took him 13 years and 137 games to do so.

For a long time, Müller also held the record for World Cup goals (14), until he was beaten by Ronaldo (15) and then Klose (16) at the 2006 World Cup.

Müller also shone in European competition: 3 European Cups, Cup Winners’ Cup, Intercontinental Cup.

Here’s the joy of one of those victories with goalkeeper Sepp Maier, with whom they pulled Bayern out of the Regionalliga.

In the replay of the Champions Cup-19 final74 Müller scored a brace against Atlético Madrid. The Spaniards lost 0:4, and some Bayern got the cup already in the opponent’s shirts.

Happy Brussels fans watched the legend play.

Müller won the German Championship and Cup 4 times. Thus, the hegemony of Bayern was born.

In the 1971/72 Bundesliga he scored 40 goals. The record for goals in a season lasted 49 years, until it was broken by Robert Lewandowski in May 2021.

Robert respectfully remembered the legend: when he scored the 40th goal, he showed a T-shirt with a photo of Müller and the caption: “4ever Gerd” (“Gerd forever”).

It was a nice gesture for a 75 year old veteran who had been suffering from illness in recent years. In 2015, Bayern reported that Müller was suffering from dementia, progressing due to Alzheimer’s syndrome. His condition only worsened. Müller lived in a nursing home (in the intensive care unit), where he was cared for by doctors, his wife, friend Paul Breitner – Gerd did not recognize his relatives, hardly ate, did not walk or talk.

Photo: globallookpress.com/imago sportfotodienst, Karl Schnörrer/dpa, SVEN SIMON; East News/EAST NEWS

Gerd Kroske: Now everyone is interested in private stories

06/11/2019 – Article

The Blick Film Festival, organized by the Goethe-Institut, opens in Moscow. This year’s main theme is masculinity. One of the main events of the program is the screening of Gerd Kroske’s documentary “Prince of Boxing”.

The film is about Norbert Grup, a boxer and actor who made his way from the red-light district of Hamburg to Hollywood.

In America, the Group is known by the stage name Prince Wilhelm von Homburg. Of course, he was never a prince, but he still remains a legendary person. A boxer who became famous for scandalous fights, a friend and assistant of criminal authorities who ruled in the St. Pauli district of Hamburg, an artist who starred in Werner Herzog’s “Stroszek” and played the Carpathian ruler Vigo in “Ghostbusters 2”. In 2002, a few years before Grupe’s death, German filmmaker Gerd Kroske made a documentary about him, which became both a private biography and a portrait of the Hamburg shadow world of the 60s and 70s. At least two episodes from this picture have become memes. The first is Norbert Grupe’s provocative interview with sports journalist Rainer Günzler: at some point, the boxer decided to simply ignore his interlocutor and answered all his uncomfortable questions with silence and a smile. The second is a walk of the filmmakers with the former pimp Stefan Hentschel, who right in front of the camera hit a random passer-by, illustrating with this gesture the whole essence of the neighborhood mores of the past. A Germania-online correspondent contacted Gerd Kroske on the eve of his visit to Moscow and asked the director about the difficult hero.

– How did the idea for the film come about? Why did you decide to make him the character of Norbert Grupe?

– I have a close friend who is a boxing expert and connoisseur. We talked a lot on this topic, and in our conversations the name Grupe constantly popped up. But even my friend by the end of the 90s did not know what became of him and where he lives. This is where curiosity kicked in. I was just on business in Hamburg at the time, and I went to one of the most famous establishments in the St. Pauli area “Zur Ritze” – a bar with a boxing ring. His owner, unfortunately, is no longer alive, but he was a well-known person in narrow circles. A boxer and a native of the GDR who moved to the West. He seemed to know everyone who had ever put on boxing gloves. But he hadn’t heard anything about Norbert either. I started digging further. The indications varied. Some said that Grupe worked as a taxi driver somewhere in the vicinity of Hamburg, others that he settled in New York. Still others had a version that Grupe became a banker in Moscow. In parallel, I heard a lot of amazing stories about him.

– And how did you find it?
– Remembered that he had acted in films and contacted the American Actors Guild. It turned out that Grupe lives in Los Angeles. In relation to the film, he was initially not very sympathetic. But then we met twice in person. Of course, I had to explain to him that I didn’t have a Hollywood offer, that I was doing documentaries, they didn’t pay much money here. These negotiations took time, but in the end he agreed to work with me. It was much more difficult to find people from his former environment who would agree to talk about him on camera and recall stories from the past. They can be understood, considering what kind of environment it was. Each interlocutor had to look for a personal approach.

– What impressed you the most in your communication with the Group?
– His unpredictability. He could be open, friendly, attentive. But five minutes later, all these qualities turned into their complete opposite.

– Who was he for you in the first place, an athlete or an artist?
– It certainly had an artistic beginning. In his youth, his father took him to America. They started with competitive wrestling. They performed together, often in some kitsch outfits: in horned Viking helmets, for example, or in gladiator armor. Then Norbert changed wrestling to boxing, but he brought an element of the show there, which was not very typical for that era.

– There is a shocking scene in the film: one of the characters, Stefan Hentschel, punches a stranger in the face who disturbed him right during the shooting. Tell me, how can a director keep his composure in such a situation?

– This question is more likely to be addressed to the operator. Moreover, on the “Prince of Boxing” we had a woman, Suzanne Schule, as an operator. In fact, at such a moment you have to decide whether to stop shooting or not. For us, this blow to the face was also a shock. But the conflict did not escalate, and we continued filming.

Stefan Hentschel was also a Hamburg legend, pimp and boxer, godfather of the red light district. But by the time we started making the film, he was done with all that. He had a cleaning company that serviced nursing homes. At first we wanted to do an interview there, but the owner was against it: it would cast a shadow on the image of a “pensioner’s paradise”. So we ended up going to St. Pauli anyway, where everyone knew Hentschel. And he tried very hard to impress the camera, to save face. The man who called out to him on the street annoyed him by ruining this moment. Oh, and then I got it for leaving this scene in the film … A foreigner is also beaten there.

– Do people like Hentschel still exist?
– No, those days are long gone. Hentstel himself subsequently became very impoverished and could barely make ends meet. For the film, I also spoke with the prosecutor who was involved in the case against the Hamburg branch of the Hells Angels motorcycle club. So he regretted that the former transparency was gone from criminal investigations. Previously, it was clear who was doing business with whom. And now there is an Albanian mafia, a Turkish mafia – it is difficult to understand these intricacies.

– Why did Grupe have so few roles in Hollywood? He definitely had potential. And he starred in at least one blockbuster – Ghostbusters 2.
– He had quite a few roles, but not the first plan. He remained an artist of a very limited role. Most often, directors saw him in the roles of villains – because of his specific charm. In addition, because of his changeable disposition, he was not an easy partner. Several times I witnessed him arguing with his agent. Other actors who have worked with Grupe have said, “Never again.”

– This year’s Blick theme is masculinity. What does this concept mean to you in the context of The Prince of Boxing?
– I haven’t reviewed it myself for a long time. And now, when such heated debates are going on in our society, the picture will probably look somehow different. But, whatever one may say, this is a detailed male portrait. And here’s what’s interesting. When we released “The Prince of Boxing” on the screens, the distributors confidently said that our potential audience is men in their fifties who remember something about that era, love boxing. However, the forecast did not come true. Instead of mature men, girls around the age of thirty came to cinemas.

When talking about masculinity and the position of women, I also always emphasize that things were different in the east and west of Germany. I grew up in the GDR, where women at least had financial independence. Everyone around me worked. I don’t remember housewives. And in Germany, until the 70s, married women had to obtain a work permit from their husband.

– Last year, two extraordinary films about East Germany came out: Between the Rows by Thomas Stuber and Gundermann by Andreas Dresen. Don’t you think that something has changed in the portrayal of East Germans in films? I have a feeling that people have finally come to the fore, not politics or clichés.
– Yes, this is a modern trend. Now everyone is interested in private stories. Although documentaries have been working on this topic for a long time, my colleagues and I have made films about little people from East Germany before.