Fass Ofer Z, Fass Ronnie
Department of Medicine, New York University Langone Health, New York, NY, USA.
Esophageal and Swallowing Center, Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA.
Curr Treat Options Gastroenterol. 2019 Mar;17(1):161-164. doi: 10.1007/s11938-019-00224-7.
ᅟRefractory GERD is very common, and while many different underlying mechanisms have been identified, the main focus has remained on residual reflux (acidic or non-acidic). Recently, Rome IV introduced two new concepts with important impact on patients with refractory GERD. They include the introduction of the reflux hypersensitivity group and the proposal that GERD can overlap with a functional esophageal disorder. Recent studies have demonstrated that the latter affects approximately three quarters of the GERD patients who failed PPI once daily.
难治性胃食管反流病（GERD）非常常见，虽然已经确定了许多不同的潜在机制，但主要关注点仍在于残余反流（酸性或非酸性）。最近，罗马IV标准引入了两个对难治性GERD患者有重要影响的新概念。它们包括反流高敏组的引入以及GERD可与功能性食管疾病重叠的提议。最近的研究表明，后者影响了约四分之三每日一次使用质子泵抑制剂（PPI）治疗失败的GERD患者。
