Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, IL 60637, United States.
World J Gastroenterol. 2010 Aug 14;16(30):3745-9. doi: 10.3748/wjg.v16.i30.3745.
This review focuses on the pathophysiology of gastroesophageal reflux disease (GERD) and its implications for treatment. The role of the natural anti-reflux mechanism (lower esophageal sphincter, esophageal peristalsis, diaphragm, and trans-diaphragmatic pressure gradient), mucosal damage, type of refluxate, presence and size of hiatal hernia, Helicobacter pylori infection, and Barrett's esophagus are reviewed. The conclusions drawn from this review are: (1) the pathophysiology of GERD is multifactorial; (2) because of the pathophysiology of the disease, surgical therapy for GERD is the most appropriate treatment; and (3) the genesis of esophageal adenocarcinoma is associated with GERD.
这篇综述主要关注胃食管反流病（GERD）的病理生理学及其对治疗的影响。文中回顾了天然抗反流机制（食管下括约肌、食管蠕动、膈肌和膈下压力梯度）、黏膜损伤、反流物类型、食管裂孔疝的存在和大小、幽门螺杆菌感染和巴雷特食管的作用。从这篇综述中得出的结论是：（1）GERD 的病理生理学是多因素的；（2）由于疾病的病理生理学，GERD 的手术治疗是最合适的治疗方法；（3）食管腺癌的发生与 GERD 有关。
