Sifrim Daniel, Zerbib Frank
Center for Gastroenterological Research, Katholieke Universiteit Leuven, Leuven, Belgium.
Curr Opin Gastroenterol. 2002 Jul;18(4):447-53. doi: 10.1097/00001574-200207000-00009.
Gastroesophageal reflux disease (GERD) affects many patients and has a negative effect on quality of life. Along with the increasing prevalence of GERD is an increase in GERD-related complications, including Barrett esophagus and esophageal adenocarcinoma. The past year has yielded new insights into the pathophysiology of GERD that can help us to better understand the relationship between reflux episodes and symptoms of mucosal damage and to provide a tailored treatment targeting individual pathophysiologic defects. The issues addressed in this report include gastric secretory and motor dysfunction; failure of the antireflux barrier caused by hiatal hernia and transient lower esophageal sphincter relaxations; characterization of the refluxate, particularly of nonacid reflux; prevalence and prognostic value of esophageal dysmotility in GERD; presence and eradication of Helicobacter pylori; Barrett esophagus and extraesophageal manifestations of GERD; and, finally, advances in medical, endoscopic, and surgical treatments of GERD.
胃食管反流病（GERD）影响着众多患者，对生活质量产生负面影响。随着GERD患病率的上升，GERD相关并发症也在增加，包括巴雷特食管和食管腺癌。过去一年，人们对GERD的病理生理学有了新的认识，这有助于我们更好地理解反流发作与黏膜损伤症状之间的关系，并针对个体病理生理缺陷提供个性化治疗。本报告所涉及的问题包括胃分泌和运动功能障碍；食管裂孔疝和食管下括约肌短暂松弛导致的抗反流屏障功能失效；反流物的特征，尤其是非酸性反流；GERD中食管动力障碍的患病率和预后价值；幽门螺杆菌的存在与根除；巴雷特食管和GERD的食管外表现；最后是GERD的药物、内镜和手术治疗进展。
