胃食管反流病检查与管理中的个性化方法
Personalized Approach in the Work-up and Management of Gastroesophageal Reflux Disease.
作者信息
Yadlapati Rena, Pandolfino John E
机构信息
Division of Gastroenterology, University of California San Diego, 9500 Gilman Drive MC 0956, La Jolla, CA 92093, USA.
Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine, 676 North St. Clair Street, Chicago, IL 60611, USA.
出版信息
Gastrointest Endosc Clin N Am. 2020 Apr;30(2):227-238. doi: 10.1016/j.giec.2019.12.002. Epub 2020 Jan 22.
Abstract
Patients with gastroesophageal reflux disease (GERD) present with heterogeneous symptoms, response to treatment, and physiologic profiles, requiring distinct and personalized management. This article provides a stepwise framework to phenotype GERD beginning with (1) characterization of symptom profile and response to acid suppression; (2) endoscopic evaluation of mucosal and anatomic integrity; (3) ambulatory reflux monitoring to characterize reflux burden and sensitivity; and (4) esophageal physiologic testing to assess gastroesophageal reflux mechanism and effectors of reflux clearance, and evaluate for alternate causes.
摘要
胃食管反流病（GERD）患者表现出不同的症状、对治疗的反应和生理特征，需要进行独特的个性化管理。本文提供了一个逐步的框架，用于对GERD进行表型分析，首先是（1）症状特征和对抑酸治疗反应的表征；（2）黏膜和解剖结构完整性的内镜评估；（3）动态反流监测以表征反流负担和敏感性；以及（4）食管生理测试，以评估胃食管反流机制和反流清除效应器，并评估其他病因。
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本文引用的文献
1
Clinical outcomes of laryngopharyngeal reflux treatment: A systematic review and meta-analysis.喉咽反流治疗的临床结果：一项系统评价和荟萃分析。
Laryngoscope. 2019 May;129(5):1174-1187. doi: 10.1002/lary.27591. Epub 2018 Dec 30.
2
Proton Pump Inhibitor-Refractory Gastroesophageal Reflux Disease.质子泵抑制剂难治性胃食管反流病。
Med Clin North Am. 2019 Jan;103(1):15-27. doi: 10.1016/j.mcna.2018.08.002. Epub 2018 Nov 1.
3
Modern diagnosis of GERD: the Lyon Consensus.现代 GERD 诊断：里昂共识。
Gut. 2018 Jul;67(7):1351-1362. doi: 10.1136/gutjnl-2017-314722. Epub 2018 Feb 3.
4
A Randomized Double-Blind, Placebo-Controlled, Cross-Over Study Using Baclofen in the Treatment of Rumination Syndrome.一项使用巴氯芬治疗反刍综合征的随机双盲、安慰剂对照、交叉研究。
Am J Gastroenterol. 2018 Jan;113(1):97-104. doi: 10.1038/ajg.2017.441. Epub 2017 Dec 5.
5
Postprandial High-Resolution Impedance Manometry Identifies Mechanisms of Nonresponse to Proton Pump Inhibitors.餐后高分辨率阻抗测压可明确质子泵抑制剂治疗无应答的机制。
Clin Gastroenterol Hepatol. 2018 Feb;16(2):211-218.e1. doi: 10.1016/j.cgh.2017.09.011. Epub 2017 Sep 12.
6
A review of medical therapy for proton pump inhibitor nonresponsive gastroesophageal reflux disease.质子泵抑制剂无反应性胃食管反流病的药物治疗综述
Dis Esophagus. 2017 Sep 1;30(9):1-15. doi: 10.1093/dote/dox055.
7
Ambulatory reflux monitoring for diagnosis of gastro-esophageal reflux disease: Update of the Porto consensus and recommendations from an international consensus group.门诊反流监测在胃食管反流病诊断中的应用：波尔图共识更新及国际共识专家组建议。
Neurogastroenterol Motil. 2017 Oct;29(10):1-15. doi: 10.1111/nmo.13067. Epub 2017 Mar 31.
8
Validation of criteria for the definition of transient lower esophageal sphincter relaxations using high-resolution manometry.使用高分辨率测压法验证暂时性下食管括约肌松弛定义标准
Neurogastroenterol Motil. 2017 Feb;29(2). doi: 10.1111/nmo.12920. Epub 2016 Jul 31.
9
Meta-analysis of the efficacy of proton pump inhibitors for the symptoms of laryngopharyngeal reflux.质子泵抑制剂治疗喉咽反流症状疗效的荟萃分析。
Braz J Med Biol Res. 2016 Jul 4;49(7). doi: 10.1590/1414-431X20165149.
10
Functional Esophageal Disorders.功能性食管疾病
Gastroenterology. 2016 Feb 15. doi: 10.1053/j.gastro.2016.02.012.
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