Hentschel Florian, Lüth Stefan
Zentrum für Innere Medizin II, Hochschulklinikum Brandenburg, Medizinische Hochschule Brandenburg, Hochstr. 29, 14770, Brandenburg an der Havel, Deutschland.
Internist (Berl). 2019 May;60(5):533-539. doi: 10.1007/s00108-019-0586-7.
Because of its high incidence gastroesophageal reflux disease (GERD) is at the forefront of medical attention. On the other hand, vigilance for rare inflammatory diseases of the esophagus, such as herpes esophagitis, radiation-induced esophagitis, eosinophilic esophagitis, pseudodiverticulosis and Crohn's disease is low. Moreover, these entities are rarely distinguishable from GERD by clinical features alone. For all atypical and treatment refractory supposedly reflux diseases, the diagnosis should therefore be questioned and re-evaluated by endoscopy. When the macroscopic findings of esophagoscopy are ambiguous biopsies can be performed and histological examination then often leads to a definitive diagnosis. This is particularly important because the required treatment of rare forms of esophagitis often significantly differs from that of GERD.
由于胃食管反流病(GERD)的高发病率,它成为了医学关注的焦点。另一方面,对于食管罕见的炎症性疾病,如疱疹性食管炎、放射性食管炎、嗜酸性食管炎、假性憩室病和克罗恩病的警惕性较低。此外,仅凭临床特征很难将这些疾病与GERD区分开来。因此,对于所有非典型的、治疗难治的疑似反流性疾病,都应通过内镜检查对诊断提出质疑并重新评估。当食管镜检查的宏观表现不明确时,可以进行活检,组织学检查往往能得出明确的诊断。这一点尤为重要,因为罕见形式的食管炎所需的治疗通常与GERD有很大不同。