Vela Marcelo F
Division of Gastroenterology, Mayo Clinic Arizona, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA.
Gastrointest Endosc Clin N Am. 2014 Oct;24(4):655-66. doi: 10.1016/j.giec.2014.07.002. Epub 2014 Jul 30.
Gastroesophageal reflux disease (GERD) is frequently diagnosed by symptoms and good response to acid suppression with proton pump inhibitors. Further work up is required when the diagnosis of GERD is uncertain, for alarm symptoms, PPI-refractoriness, and often for extraesophageal presentations. Useful tools include endoscopy for mucosal assessment and reflux monitoring (pH or impedance-pH) to quantify reflux burden. Objective documentation of pathological reflux is mandatory prior to anti-reflux surgery. In some patients, symptoms that can be attributed to GERD may have other causes; in these patients, testing that excludes GERD helps direct the diagnostic and treatment efforts to other causes.
胃食管反流病（GERD）通常根据症状以及使用质子泵抑制剂进行抑酸治疗后的良好反应来诊断。当GERD的诊断不确定、出现警示症状、对质子泵抑制剂治疗无效，以及通常在出现食管外表现时，需要进一步检查。有用的检查手段包括用于评估黏膜的内镜检查和用于量化反流负荷的反流监测（pH或阻抗-pH监测）。在进行抗反流手术之前，必须有病理反流的客观记录。在一些患者中，可归因于GERD的症状可能有其他原因；在这些患者中，排除GERD的检查有助于将诊断和治疗方向指向其他病因。
