Herrmann I F, Scarpignato C
HNO-Abteilung, European Hospital, Via Portuense 700, 00149, Rom, Italien.
HNO. 2009 Dec;57(12):1221-36. doi: 10.1007/s00106-009-1934-z.
ENT specialists and gastroenterologists are increasingly confronted with the question of how to recognize and evaluate extra-esophageal complications of reflux. Both specialities need to collaborate, since they are connected via the esophagus, and both need to know more about the speciality of their neighbor than was hitherto usual. This publication presents the observations and measurements of little-known physiological functions. This is followed by an attempt to define the border between healthy and diseased. Finally, the possible consequences of functional disorders are described. The leap from observation of function to the microcosm of biochemical links is discussed and supported using experimental work. This overview highlights the limitations of our current knowledge. The success of functional endoscopy in terms of therapeutic approaches is immense. The required therapy is finally based on a clear diagnostic concept; probatory therapy is a waste of money.
耳鼻喉科专家和胃肠病学家越来越多地面临如何识别和评估反流的食管外并发症这一问题。由于这两个专业通过食管相互关联,因此两者需要合作,并且彼此都需要比以往更多地了解相邻专业的知识。本出版物展示了鲜为人知的生理功能的观察结果和测量数据。随后尝试界定健康与疾病之间的界限。最后,描述了功能障碍可能产生的后果。文中讨论并借助实验工作支持了从功能观察到生化联系微观世界的跨越。这一综述突出了我们现有知识的局限性。功能性内镜检查在治疗方法方面取得了巨大成功。所需的治疗最终基于清晰的诊断概念;试验性治疗是浪费金钱。