胃食管反流病的诊断和治疗:当前的见解。

IF 2.5 Q2 GASTROENTEROLOGY & HEPATOLOGY
Clinical and Experimental Gastroenterology Pub Date : 2025-07-08 eCollection Date: 2025-01-01 DOI:10.2147/CEG.S507237
Abhinav Vayal-Veettil, C Prakash Gyawali
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引用次数: 0

摘要

胃食管反流病(GERD)是由胃内容物逆行运动进入食管及其他部位引起的,可导致症状、粘膜损伤和长期并发症。典型的胃灼热和反流症状高度提示胃食管反流,但不典型的表现需要仔细评估,以排除其他诊断。诊断方式,包括内窥镜检查、动态反流监测和高分辨率测压,在确认胃食管反流和指导个性化治疗方面发挥着关键作用。管理策略包括生活方式的改变,抗分泌药物的药物治疗,以及海藻酸盐和巴氯芬等辅助治疗。对于难治性病例,手术和内窥镜干预提供持久的症状缓解。反流胃食管反流的并发症可发生在食管或食管外,因此早期诊断和有效治疗非常重要。通过适当的治疗,GERD的预后通常是良好的,尽管难治性病例需要量身定制的方法来解决重叠的情况,如肠-脑相互作用障碍和行为障碍。多学科,以患者为中心的方法优化了结果,提高了胃食管反流患者的生活质量。这篇综述提供了当前对胃食管反流的见解的全面概述,重点是临床表现、诊断策略和治疗选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnosis and Management of Gastroesophageal Reflux Disease: Current Insights.

Gastroesophageal reflux disease (GERD) results from retrograde movement of gastric content into the esophagus and beyond, resulting in symptoms, mucosal injury and long-term complications. Typical symptoms of heartburn and regurgitation are highly suggestive of GERD, but atypical presentations require careful evaluation to rule out alternative diagnoses. Diagnostic modalities, including endoscopy, ambulatory reflux monitoring, and high-resolution manometry, play a pivotal role in confirming GERD and guiding personalized treatment. Management strategies consist of lifestyle modifications, pharmacologic therapy with anti-secretory agents, and adjunctive treatments such as alginates and baclofen. For refractory cases, surgical and endoscopic interventions offer durable symptom relief. Complications of GERD can be esophageal or extraesophageal, and highlight the importance of early diagnosis and effective management. The prognosis for GERD is generally favorable with appropriate treatment, although refractory cases require a tailored approach to address overlapping conditions such as disorders of gut-brain interaction and behavioral disorders. A multidisciplinary, patient-centered approach optimizes outcomes and improves the quality of life for individuals with GERD. This review provides a comprehensive overview of current insights into GERD, focusing on clinical presentation, diagnostic strategies, and therapeutic options.

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来源期刊
Clinical and Experimental Gastroenterology
Clinical and Experimental Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.10
自引率
0.00%
发文量
26
审稿时长
16 weeks
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