Nagahara Akihito, Shiotani Akiko, Iijima Katsunori, Kamada Tomoari, Fujiwara Yasuhiro, Kasugai Kunio, Kato Mototsugu, Higuchi Kazuhide
Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan.
Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, Okayama, Japan.
Dig Endosc. 2022 Jan;34(1):63-72. doi: 10.1111/den.13982. Epub 2021 Apr 22.
The Japan Gastroenterological Endoscopy Society held four serial symposia between 2019 and 2020 on the state-of-the-art of issues related to upper GI inflammatory diseases. This review discusses some of the topics addressed in these symposia. The papers regarding nonerosive reflux disease, recent improvements in intraesophageal pH-impedance monitoring and endoscopic diagnosis using image-enhanced endoscopy have been published. Many publications have addressed its usefulness in endoscopic treatment of gastroesophageal reflux disease such as anti-reflux mucosectomy. In the management of eosinophilic esophagitis, since the symptoms are subjective, objective indicators have been sought, and ultrasonography and high-resolution manometry may be useful tools for evaluation. The natural course of this condition, especially of asymptomatic cases, is not well clarified. Some newly developed anti-acid or anti-inflammatory medicines are now under investigation. With regard to autoimmune gastritis, because of widespread medical examinations, diagnosis of asymptomatic cases has been increasing. Recently, its endoscopic characteristics have become clear and the natural history of these conditions is being elucidated. The Kyoto Classification of Gastritis has been reported to be useful not only for Helicobacter pylori diagnosis but also for identification of risks of gastric cancer. Its usefulness is now recognized in Asia and Europe.
日本胃肠内镜学会在2019年至2020年期间就上消化道炎症性疾病相关的最新问题举办了四场系列研讨会。本综述讨论了这些研讨会中涉及的一些主题。关于非糜烂性反流病、食管内pH阻抗监测的最新进展以及使用内镜增强技术进行内镜诊断的相关论文已经发表。许多出版物都论述了其在胃食管反流病内镜治疗（如抗反流黏膜切除术）中的实用性。在嗜酸性食管炎的管理方面，由于症状具有主观性，因此一直在寻找客观指标，超声检查和高分辨率测压可能是有用的评估工具。这种疾病的自然病程，尤其是无症状病例的自然病程，尚未得到充分阐明。一些新开发的抗酸或抗炎药物目前正在研究中。关于自身免疫性胃炎，由于广泛开展体检，无症状病例的诊断有所增加。最近，其内镜特征已变得清晰，这些疾病的自然史正在得到阐明。据报道，胃炎的京都分类不仅对幽门螺杆菌诊断有用，而且对胃癌风险的识别也有用。其实用性目前在亚洲和欧洲已得到认可。
