Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland.
Ann N Y Acad Sci. 2013 Oct;1300:166-186. doi: 10.1111/nyas.12240.
This paper presents commentaries on how endoluminal antireflux procedures compare to laparoscopic fundoplication; new endoscopic procedures being studied to treat refractory gastroesophageal reflux disease (GERD); the new Stretta; the relationship between obesity and proton pump inhibitor (PPI) resistance; data concerning acid hypersensitivity and sensory receptors (vallinoid, TRPV1) causing refractory GERD; whether microscopic esophagitis is relevant in determining symptoms of non-erosive reflux disease (NERD); how concomitant functional gastrointestinal disorders affect the PPI response in NERD; the evidence that a functional esophagus is associated with inflammatory bowel syndrome (IBS); the role of GABA agonists in the treatment of refractory GERD; the role of biofeedback and antidepressants in refractory GERD; and endoluminal fundoplication using the EsophyX device.
本文就内镜抗反流术与腹腔镜胃底折叠术的对比进行了评论；介绍了一些新的内镜治疗方法，旨在治疗难治性胃食管反流病（GERD）；新型 Stretta 技术；肥胖与质子泵抑制剂（PPI）抵抗之间的关系；有关酸敏感性和感觉受体（辣椒素、TRPV1）导致难治性 GERD 的数据；微观食管炎在确定非糜烂性反流病（NERD）症状方面是否具有相关性；同时存在的功能性胃肠道疾病如何影响 NERD 中 PPI 的反应；功能性食管与炎症性肠病（IBS）相关的证据；GABA 激动剂在难治性 GERD 治疗中的作用；生物反馈和抗抑郁药在难治性 GERD 中的作用；以及使用 EsophyX 设备进行内镜下胃底折叠术。
