Veterans Affairs Medical Center and University of Kansas School of Medicine, Kansas City, KS, USA.
Best Pract Res Clin Gastroenterol. 2013 Jun;27(3):433-42. doi: 10.1016/j.bpg.2013.07.002.
Gastro-oesophageal reflux disease (GORD) is on the rise with more than 20% of the western population reporting symptoms and is the most common gastrointestinal disorder in the United States. This increase in GORD is not exactly clear but has been attributed to the increasing prevalence of obesity, changing diet, and perhaps the decreasing prevalence of H. pylori infection. Complications of GORD could be either benign or malignant. Benign complications include erosive oesophagitis, bleeding and peptic strictures. Premalignant and malignant lesions include Barrett's metaplasia, and oesophageal cancer. Management of both the benign and malignant complications can be challenging. With the use of proton-pump inhibitors, peptic strictures (i.e., strictures related to reflux) have significantly declined. Several aspects of Barrett's management remain controversial including the stage in the disease process which needs to be intervened, type of the intervention and surveillance of these lesions to prevent development of high grade dysplasia and oesophageal adenocarcinoma.
胃食管反流病（GORD）的发病率正在上升，超过 20%的西方人口报告有症状，是美国最常见的胃肠道疾病。GORD 的这种增加并不十分清楚，但归因于肥胖症的流行、饮食的改变，也许还有幽门螺杆菌感染的流行率降低。GORD 的并发症可能是良性的，也可能是恶性的。良性并发症包括糜烂性食管炎、出血和消化性狭窄。癌前病变和恶性病变包括 Barrett 化生和食管癌。良性和恶性并发症的管理都具有挑战性。随着质子泵抑制剂的使用，消化性狭窄（即与反流相关的狭窄）显著减少。Barrett 管理的几个方面仍然存在争议，包括需要干预的疾病阶段、干预的类型以及这些病变的监测，以预防高级别发育不良和食管腺癌的发生。
