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消化不良与胃食管反流病(GERD):二者存在关联吗?

Dyspepsia and gastroesophageal reflux disease (GERD): is there any correlation?

作者信息

Simadibrata Marcellus

机构信息

Department of Internal Medicine, University of Indonesia, Jakarta Pusat 10430,

出版信息

Acta Med Indones. 2009 Oct;41(4):222-7.

Abstract

Dyspepsia is a syndrome characterized by symptoms and signs of upper gastrointestinal tract and the adjacent organs. It is estimated that 25% of the community have symptoms of dyspepsia syndrome. One-third of patients who visit general physician practices are patients with dyspepsia syndrome; and half of patients who visit gastroenterologists are also patients with dyspepsia syndrome. Dyspepsia syndrome and gastroesophageal reflux disease (GERD) are very prevalent in the community throughout the world.Gastroesophageal reflux disease (GERD) is more and more commonly found in daily medical practice. Until now,the natural history of disease on GERD and dyspepsia is hardly understood, even though many scientists studied both conditions and there are frequently overlapping. In an individual, GERD and dyspepsia may occur simultaneously and therefore they are hardly to be discriminated.The management of GERD is performed in keeping with Indonesia and Asia Pacific consensus, life-style modification and administering the acid suppression agents (Proton pump inhibitor (drug of choice), H2-receptor antagonist, etc),prokinetic agents (Cisapride, domperidone, etc). Life-style modification shall be performed as follows, i.e. sleep with 30-45 degree elevated head or upper chest, do not avoid sour beverages, chocolate, coffee or alcohol, avoid fat and various fried foods, sour food, less stress, stop smoking, small but frequent feeding, etc. There is a correlation between dyspepsia syndrome and gastroesophageal reflux disease(GERD), particularly between the functional dyspepsia and non-erosive gastroesophageal reflux (NERD). More appropriate definition is necessary to differentiate the dyspepsia syndrome and GERD. Further studies are needed to establish distinct definition and criteria between dyspepsia syndrome and GERD.

摘要

消化不良是一种以上消化道及相邻器官的症状和体征为特征的综合征。据估计,25%的人群有消化不良综合征的症状。到普通内科就诊的患者中有三分之一是消化不良综合征患者;而到胃肠病科就诊的患者中有一半也是消化不良综合征患者。消化不良综合征和胃食管反流病(GERD)在全球范围内都非常普遍。胃食管反流病(GERD)在日常医疗实践中越来越常见。到目前为止,尽管许多科学家对GERD和消化不良这两种情况都进行了研究,且它们常常相互重叠,但人们对这两种疾病的自然病史仍知之甚少。在个体中,GERD和消化不良可能同时发生,因此很难区分。GERD的治疗遵循印度尼西亚和亚太地区的共识,即改变生活方式并使用抑酸剂(质子泵抑制剂(首选药物)、H2受体拮抗剂等)、促动力剂(西沙必利、多潘立酮等)。生活方式的改变应如下进行,即睡觉时将头部或上胸部抬高30 - 45度,不忌酸性饮料、巧克力、咖啡或酒精,避免食用脂肪和各种油炸食品、酸性食物,减轻压力,戒烟,少食多餐等。消化不良综合征与胃食管反流病(GERD)之间存在关联,特别是功能性消化不良与非糜烂性胃食管反流(NERD)之间。需要更恰当的定义来区分消化不良综合征和GERD。需要进一步研究以确立消化不良综合征和GERD之间明确的定义和标准。

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