Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois.
JAMA Surg. 2016 Jan;151(1):73-8. doi: 10.1001/jamasurg.2015.4233.
Gastroesophageal reflux disease (GERD) is prevalent worldwide, particularly in developed countries. It is estimated that the prevalence of GERD in the United States is approximately 20% and that it is increasing because of the epidemic of obesity.
To review the pathophysiology, clinical presentation, diagnostic evaluation, and treatment of GERD.
A search of PubMed was conducted for the years spanning 1985 to 2015 and included the following terms: heartburn, regurgitation, dysphagia, gastroesophageal reflux disease, cough, aspiration, laryngitis, GERD, GORD, endoscopy, manometry, pH monitoring, proton pump inhibitors, open fundoplication, and laparoscopic fundoplication. Only articles in English were included.
Lifestyle modifications, proton pump inhibitors, and laparoscopic fundoplication are proven treatment modalities for GERD. Endoscopic procedures have not been proven as effective. A Roux-en-Y gastric bypass is the procedure of choice when GERD and morbid obesity coexist.
Gastroesophageal reflux disease is a highly prevalent disease. Once the diagnosis has been established, the best results are obtained by a multidisciplinary team with the goal of individualizing treatment for patients.
胃食管反流病（GERD）在全球范围内普遍存在，尤其是在发达国家。据估计，美国的 GERD 患病率约为 20%，由于肥胖症的流行，其患病率还在不断上升。
回顾 GERD 的病理生理学、临床表现、诊断评估和治疗方法。
对 1985 年至 2015 年期间的 PubMed 进行了检索，使用了以下术语：烧心、反流、吞咽困难、胃食管反流病、咳嗽、吸入、喉炎、GERD、GORD、内镜检查、测压法、pH 监测、质子泵抑制剂、开放胃底折叠术和腹腔镜胃底折叠术。仅纳入英文文章。
生活方式改变、质子泵抑制剂和腹腔镜胃底折叠术是 GERD 的有效治疗方法。内镜治疗方法尚未被证实有效。当 GERD 和病态肥胖并存时，Roux-en-Y 胃旁路术是首选的治疗方法。
胃食管反流病是一种高发疾病。一旦确诊，通过多学科团队进行个体化治疗可获得最佳效果。
