Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, Tennessee.
Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Gastroenterology. 2018 Jan;154(2):289-301. doi: 10.1053/j.gastro.2017.07.040. Epub 2017 Aug 1.
A detailed critique of objective measurements of gastroesophageal reflux disease (GERD) would improve management of patients suspecting of having reflux, leading to rational selection of treatment and better outcomes. Many diagnostic tests for GERD have been developed over the past decades. We analyze their development, positive- and negative-predictive values, and ability to predict response to treatment. These features are important for development of medical, surgical, and endoscopic therapies for GERD. We discuss the value of available diagnostic tests and review their role in management of patients with persistent reflux symptoms despite adequate medical or surgical treatment. This is becoming a significant health economic problem, due to the widespread use of proton pump inhibitors. GERD is believed to cause nonesophageal symptoms, such as those provoked by ear, nose, throat, or respiratory disorders. We analyze the value of GERD diagnostic tests in evaluation of these troublesome, nonesophageal symptoms.
详细评价胃食管反流病（GERD）的客观测量方法将改善对怀疑有反流的患者的管理，从而合理选择治疗方法并获得更好的结果。在过去的几十年中，已经开发出许多GERD 的诊断测试。我们分析了它们的发展、阳性和阴性预测值以及预测对治疗反应的能力。这些特征对于 GERD 的医学、手术和内镜治疗的发展很重要。我们讨论了现有诊断测试的价值，并回顾了它们在管理尽管经过充分的药物或手术治疗但仍持续存在反流症状的患者中的作用。由于质子泵抑制剂的广泛使用，这正在成为一个重大的健康经济问题。GERD 被认为会引起非食管症状，例如耳、鼻、喉或呼吸障碍引起的症状。我们分析了 GERD 诊断测试在评估这些麻烦的非食管症状中的价值。
