a Unit of Gastroenterology and Digestive Endoscopy, University Campus Bio Medico , Rome , Italy.
Expert Rev Gastroenterol Hepatol. 2019 Aug;13(8):761-769. doi: 10.1080/17474124.2019.1645596. Epub 2019 Jul 25.
: Gastroesophageal reflux disease (GERD) is a very common and often debilitating disease. In the broad spectrum of GERD phenotypes, three main groups may be traditionally distinguished: 1) patients only affected by esophageal and/or extra-esophageal symptoms; 2) patients with erosive esophagitis and 3) patients with further complications. : This review provides an overview on the current classifications of GERD patients, and their impact on their management. : In 2017, the GERD Consensus Working Group focused the attention on patients unresponsive to PPIs. In this scenario, a diagnosis of GERD might be confirmed by evident signs of erosive esophagitis and the finding of pH or multichannel intraluminal impedance-pH tests, such as more than 6%. The 'Lyon Consensus' panel of experts confirmed that positive indices of reflux-symptom association, without other altered parameters, represent reflux hypersensitivity. GERD requires a customized management; it is crucial to assess frequency and severity of symptoms and their response to an optimal course of therapy as well as to explore the endoscopic alterations and consider other diagnoses responsible for persistent symptoms.
胃食管反流病（GERD）是一种非常常见且常常使人虚弱的疾病。在 GERD 的广泛表型中，传统上可以区分出三个主要群体：1）仅受食管和/或食管外症状影响的患者；2）有糜烂性食管炎的患者和 3）有进一步并发症的患者。本文综述了 GERD 患者的当前分类及其对其管理的影响。2017 年，GERD 共识工作组关注对 PPI 无反应的患者。在这种情况下，GERD 的诊断可以通过明显的糜烂性食管炎迹象和 pH 或多通道腔内阻抗-pH 测试的发现来确认，例如超过 6%。里昂共识专家组专家确认，反流-症状关联的阳性指标，没有其他改变的参数，代表反流过敏。GERD 需要个性化管理；评估症状的频率和严重程度及其对最佳疗程的反应，以及探索内镜改变并考虑其他导致持续症状的诊断至关重要。
