Gerards C, Peitz U, Malfertheiner P
Klinik für Gastroenterologie und Hepatologie, Otto-von-Guericke Universität Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Deutschland.
Ther Umsch. 2001 Mar;58(3):137-45. doi: 10.1024/0040-5930.58.3.137.
Gastroesophageal reflux disease (GERD) is a common disease increasing in incidence and prevalence in the industrialised countries. It is a chronic disease with a large spectrum of clinical manifestations. The leading symptom is heartburn, however the disease may also present with extraesophageal symptoms or stay asymptomatic. Motility disorders of the upper GI tract with the key feature of impaired LES are the cause for pathologic gastroesophageal reflux in the terminal esophagus. The relationship of H. pylori infection with GERD is part of the current discussion. The Savary Miller classification for grading of refluxesophagitis is now proposed for substitution by the Los Angeles classification for the assessment of erosive lesions. Besides complications such as bleeding or strictures the main risk is the development of Barrett esophagus and adenocarcinoma. Proton pump inhibitors are the therapy of choice for healing as well as in longterm therapy and prophylaxis. New endoscopic interventional therapies for treatment of GERD and related diseases should be used only in controlled studies.
胃食管反流病(GERD)是一种在工业化国家发病率和患病率不断上升的常见疾病。它是一种具有广泛临床表现的慢性疾病。主要症状是烧心,但该疾病也可能表现为食管外症状或无症状。以上消化道动力障碍为主要特征,其中LES功能受损是食管末端病理性胃食管反流的原因。幽门螺杆菌感染与胃食管反流病的关系是当前讨论的一部分。目前建议用洛杉矶分类法替代用于评估糜烂性病变的Savary Miller反流性食管炎分级分类法。除了出血或狭窄等并发症外,主要风险是巴雷特食管和腺癌的发生。质子泵抑制剂是愈合治疗以及长期治疗和预防的首选疗法。用于治疗胃食管反流病及相关疾病的新型内镜介入疗法仅应在对照研究中使用。