Ates Fehmi, Vaezi Michael F
Dr Ates is an associate professor of medicine at Mersin University in Mersin, Turkey. Dr Vaezi is a professor of medicine; clinical director of the Division of Gastroenterology, Hepatology, and Nutrition; and director of the Center for Swallowing and Esophageal Disorders at Vanderbilt University Medical Center in Nashville, Tennessee.
Gastroenterol Hepatol (N Y). 2014 Nov;10(11):729-736.
Gastroesophageal reflux disease (GERD) is a common condition that presents with symptoms of heartburn and regurgitation. Asthma is an equally common medical condition that often coexists with GERD. The clinical scenario of difficult-to-treat asthma in the setting of concomitant GERD leads to the possibility of GERD-induced asthma. However, asthma may also induce GERD, so confusion has developed about the role of GERD in patients with moderate to severe asthma. Acid-suppressive therapy may be initiated in patients with asthma, but controlled studies have recently questioned the role of such therapy and, thus, have caused further confusion in this field. Recent advancements in the field of esophageal physiologic testing in GERD have introduced the concept of impedance-pH monitoring, which suggests a possible role of nonacid reflux in those who continue to be symptomatic despite acid-suppressive therapy. However, recent data caution about the role of surgical fundoplication based solely on the results of impedance monitoring. This article reviews current knowledge in the fields of GERD and asthma and suggests a possible treatment option for this group of patients.
胃食管反流病（GERD）是一种常见疾病，表现为烧心和反流症状。哮喘是同样常见的病症，常与GERD并存。在合并GERD的情况下，难治性哮喘的临床情况提示存在GERD诱发哮喘的可能性。然而，哮喘也可能诱发GERD，因此对于GERD在中重度哮喘患者中的作用产生了混淆。哮喘患者可能开始使用抑酸治疗，但近期的对照研究对这种治疗的作用提出了质疑，从而在该领域造成了进一步的混淆。GERD食管生理检测领域的最新进展引入了阻抗 - pH监测的概念，这表明在接受抑酸治疗后仍有症状的患者中，非酸性反流可能起作用。然而，近期数据对仅基于阻抗监测结果进行手术性胃底折叠术的作用提出了警示。本文综述了GERD和哮喘领域的当前知识，并为这类患者提出了一种可能的治疗选择。
