Naik Rishi D, Evers Lauren, Vaezi Michael F
Division of Gastroenterology, Hepatology, and Nutrition, Center for Swallowing and Esophageal Disorders, Digestive Disease Center, Vanderbilt University Medical Center, 1660 TVC, Nashville, TN, 37232-5280, USA.
Curr Treat Options Gastroenterol. 2019 Mar;17(1):1-17. doi: 10.1007/s11938-019-00213-w.
Gastroesophageal reflux disease (GERD) is a common diagnosis encountered by both primary care providers and specialists, but despite its prevalence, there are limitations in the current diagnostic tests for GERD. Once an accurate diagnosis is made, treatment options can be offered, and this field continues to burgeon with options. In this review, we seek to review the recent advances in GERD diagnostics and subsequent treatment options.
Novel impedance markers and novel techniques (mucosal impedance testing, salivary pepsin, high-resolution manometry, and narrow-band imaging) have shown promise in diagnosing GERD. Advances in medical therapy, including potassium-competitive acid blockers and bile acid sequestrants, along with advances in invasive therapy (transoral incisionless fundoplication, endoscopic radiofrequency, electrical stimulation of the LES, and magnetic sphincter augmentation) have provided additional options for therapy for GERD beyond PPI and anti-reflux surgery. Novel impedance markers and techniques will provide further clarity on mucosal integrity and the barrier function allowing improved diagnostic accuracy of GERD. Improvements in medical and invasive therapy will expand GERD therapy.
胃食管反流病（GERD）是初级保健提供者和专科医生都常遇到的诊断，但尽管其发病率高，目前GERD的诊断测试仍存在局限性。一旦做出准确诊断，就可以提供治疗选择，并且这一领域的治疗选择也在不断涌现。在本综述中，我们旨在回顾GERD诊断和后续治疗选择的最新进展。
新型阻抗标志物和新技术（黏膜阻抗测试、唾液胃蛋白酶、高分辨率测压和窄带成像）在GERD诊断中显示出前景。药物治疗的进展，包括钾竞争性酸阻滞剂和胆汁酸螯合剂，以及侵入性治疗的进展（经口无切口胃底折叠术、内镜射频、LES电刺激和磁括约肌增强术），为GERD的治疗提供了除质子泵抑制剂（PPI）和抗反流手术之外的更多选择。新型阻抗标志物和技术将进一步明确黏膜完整性和屏障功能，提高GERD的诊断准确性。药物和侵入性治疗的改进将扩大GERD的治疗范围。
