Bhatia J, Parish A
Department of Pediatrics, Section of Neonatology, The Medical College of Georgia, Augusta, GA 30912, USA.
J Perinatol. 2009 May;29 Suppl 2:S7-11. doi: 10.1038/jp.2009.27.
A global evidence-based consensus has defined gastroesophageal reflux disease (GERD) as 'a condition, which develops when the reflux of stomach contents causes troublesome symptoms and/or complications.' The manifestations of GERD can be divided into esophageal and extraesophageal syndromes, and include vomiting, poor weight gain, dysphagia, abdominal or substernal/retrosternal pain, esophagitis and respiratory disorders. The extraesophageal syndromes have been divided into established and proposed associations: established would include cough, laryngitis, asthma and dental erosion ascribable to reflux, whereas proposed associations would include pharyngitis, sinusitis, idiopathic pulmonary fibrosis and recurrent otitis media. Uninvestigated patients with esophageal symptoms without evidence of esophageal injury would be considered to have asymptomatic esophageal syndromes, whereas those with demonstrable injury are considered to have esophageal syndromes with esophageal injury. Therefore, this allows symptoms to define the disease but permits further characterization if mucosal injury is found. Within the syndromes with associated injury are reflux esophagitis, stricture, Barrett's esophagitis and adenocarcinoma. This review will address definitions of GER and GERD-associated symptoms and treatment options.
一项基于全球证据的共识将胃食管反流病（GERD）定义为“一种因胃内容物反流导致出现令人不适的症状和/或并发症的病症”。GERD的表现可分为食管综合征和食管外综合征，包括呕吐、体重增加缓慢、吞咽困难、腹部或胸骨后/胸骨下疼痛、食管炎和呼吸系统疾病。食管外综合征又分为已确定的关联和推测的关联：已确定的关联包括咳嗽、喉炎、哮喘以及可归因于反流的牙齿侵蚀，而推测的关联包括咽炎、鼻窦炎、特发性肺纤维化和复发性中耳炎。未接受检查但有食管症状且无食管损伤证据的患者将被视为患有无症状食管综合征，而那些有明显损伤的患者则被视为患有伴有食管损伤的食管综合征。因此，这使得症状能够界定疾病，但如果发现黏膜损伤则允许进一步分类。伴有相关损伤的综合征包括反流性食管炎、狭窄、巴雷特食管炎和腺癌。本综述将探讨胃食管反流（GER）和GERD相关症状的定义以及治疗选择。
