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综述文章:慢性肝病中的食管疾病。

Review article: Oesophageal disorders in chronic liver disease.

机构信息

Departamento De Gastroenterología, Escuela De Medicina, Pontificia Universidad Católica De Chile, Santiago, Chile.

Faculty of Medicine, Universidad de los Andes, Santiago, Chile.

出版信息

Aliment Pharmacol Ther. 2024 Sep;60(6):715-726. doi: 10.1111/apt.18193. Epub 2024 Jul 31.

Abstract

BACKGROUND

Oesophageal disorders and chronic liver disease are common worldwide and significantly impact quality of life. The intricate link between these conditions, including how oesophageal disorders like GERD, Barrett's oesophagus and oesophageal cancer affect and are affected by chronic liver disease, remains poorly understood.

AIMS

To review the relationship between oesophageal disorders and chronic liver disease, evaluating epidemiology, pathophysiology and therapeutic factors.

METHODS

We reviewed the literature on the relationship between oesophageal disorders and chronic liver disease, including cirrhosis, using the PubMed database RESULTS: Oesophageal disorders such as gastroesophageal reflux disease, Barrett's oesophagus, oesophageal cancer, oesophageal motor disorders and oesophageal candidiasis are prevalent among individuals with cirrhosis, exacerbating the burden of liver disease. These diseases have a multifaceted symptomatology and pathogenic basis, posing a significant challenge in cirrhotic patients that necessitates careful diagnosis and management. Additionally, therapies frequently used for these diseases, such as proton pump inhibitors, require careful consideration in cirrhotic patients due to potential adverse effects and altered pharmacokinetics. Managing oesophageal disorders in cirrhotic patients requires a cautious approach due to possible interactions with medications and the risk of adverse effects. Furthermore, symptoms associated with these conditions are often exacerbated by common interventions in patients with cirrhosis, such as band ligation for oesophageal varices.

CONCLUSIONS

Oesophageal disorders are common in cirrhosis and increase the disease burden. These conditions require careful management due to complex symptoms and treatment risks. Proton pump inhibitors and other therapies must be used cautiously, as cirrhosis interventions can worsen symptoms.

摘要

背景

食管疾病和慢性肝病在全球范围内都很常见,严重影响生活质量。这些疾病之间的复杂关系,包括胃食管反流病(GERD)、巴雷特食管和食管癌等食管疾病如何影响和受慢性肝病影响,仍知之甚少。

目的

综述食管疾病与慢性肝病之间的关系,评估其流行病学、病理生理学和治疗因素。

方法

我们使用 PubMed 数据库回顾了食管疾病与慢性肝病(包括肝硬化)之间关系的文献。

结果

食管疾病如胃食管反流病、巴雷特食管、食管癌、食管动力障碍和食管念珠菌病在肝硬化患者中较为常见,加重了肝病负担。这些疾病具有复杂的症状和发病机制基础,给肝硬化患者带来了重大挑战,需要仔细诊断和管理。此外,由于潜在的不良反应和药代动力学改变,质子泵抑制剂等常用于这些疾病的治疗方法在肝硬化患者中需要谨慎考虑。由于可能与药物相互作用和不良反应的风险,管理肝硬化患者的食管疾病需要谨慎。此外,这些疾病相关症状常因肝硬化患者的常见干预措施而加重,如食管静脉曲张的套扎治疗。

结论

食管疾病在肝硬化中很常见,增加了疾病负担。这些疾病的症状复杂,治疗风险高,需要谨慎管理。质子泵抑制剂和其他疗法必须谨慎使用,因为肝硬化干预措施可能会加重症状。

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