Holtmann G, Adam B, Liebregts T
Department of Gastroenterology, Hepatology and General Medicine, Royal Adelaide Hospital, University of Adelaide, South Australia 5000, Australia.
Aliment Pharmacol Ther. 2004 Dec;20 Suppl 8:24-7. doi: 10.1111/j.1365-2036.2004.02224.x.
Gastro-oesophageal reflux disease (GERD) is a highly prevalent disorder in all Western countries. Interestingly, prevalence rates appear to be increasing in these countries, with a remarkable increase of GERD-related lethal and nonlethal complications. However, these complications are rare on a global scale. This review aims to summarize the current concepts of genetic, lifestyle and environmental factors that need to be considered whilst caring for patients with these disorders. GERD is defined by the augmented exposure of oesophageal mucosa to acidic content, and is associated with specific symptoms or mucosal lesions. A number of factors may contribute to the manifestation of GERD. Although recent studies emphasize the role of genetic factors, there are many other risk factors that play a pivotal role in the development of GERD and GERD complications. Some nutritional factors are believed to aggravate acidic reflux either by delaying gastric emptying or diminishing the pressure of the lower oesophageal sphincters. Patients are often advised to sleep with their heads elevated, but this advice is not easy to follow and has not been proven effective with regard to long-term outcome. Other lifestyle modifications include changes to the patient's diet, which are important but not frequently sufficient. Thus, medication is usually necessary for symptom control. Proton pump inhibitors are now mainstream treatment for the reduction of acid secretion in patients with severe manifestations and 4-week healing rates are approaching 90%.
胃食管反流病（GERD）在所有西方国家都是一种高度流行的疾病。有趣的是，这些国家的患病率似乎在上升，与GERD相关的致命和非致命并发症显著增加。然而，从全球范围来看，这些并发症并不常见。本综述旨在总结在照顾患有这些疾病的患者时需要考虑的遗传、生活方式和环境因素的当前概念。GERD的定义是食管黏膜暴露于酸性内容物的情况增加，并与特定症状或黏膜病变相关。许多因素可能导致GERD的表现。尽管最近的研究强调了遗传因素的作用，但还有许多其他风险因素在GERD及其并发症的发展中起着关键作用。一些营养因素被认为通过延迟胃排空或降低食管下括约肌压力来加重酸性反流。通常建议患者睡觉时将头部抬高，但这条建议不易遵循，而且在长期效果方面尚未被证明有效。其他生活方式的改变包括调整患者的饮食，这很重要但往往不够。因此，通常需要药物来控制症状。质子泵抑制剂现在是治疗严重症状患者减少胃酸分泌的主流药物，4周愈合率接近90%。
