Vayal-Veettil Abhinav, Gyawali C Prakash
Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri, USA.
Clin Exp Gastroenterol. 2025 Jul 8;18:149-162. doi: 10.2147/CEG.S507237. eCollection 2025.
Gastroesophageal reflux disease (GERD) results from retrograde movement of gastric content into the esophagus and beyond, resulting in symptoms, mucosal injury and long-term complications. Typical symptoms of heartburn and regurgitation are highly suggestive of GERD, but atypical presentations require careful evaluation to rule out alternative diagnoses. Diagnostic modalities, including endoscopy, ambulatory reflux monitoring, and high-resolution manometry, play a pivotal role in confirming GERD and guiding personalized treatment. Management strategies consist of lifestyle modifications, pharmacologic therapy with anti-secretory agents, and adjunctive treatments such as alginates and baclofen. For refractory cases, surgical and endoscopic interventions offer durable symptom relief. Complications of GERD can be esophageal or extraesophageal, and highlight the importance of early diagnosis and effective management. The prognosis for GERD is generally favorable with appropriate treatment, although refractory cases require a tailored approach to address overlapping conditions such as disorders of gut-brain interaction and behavioral disorders. A multidisciplinary, patient-centered approach optimizes outcomes and improves the quality of life for individuals with GERD. This review provides a comprehensive overview of current insights into GERD, focusing on clinical presentation, diagnostic strategies, and therapeutic options.
胃食管反流病（GERD）是由于胃内容物逆行进入食管及食管以外部位，从而导致症状、黏膜损伤及长期并发症。烧心和反流等典型症状高度提示GERD，但非典型表现则需要仔细评估以排除其他诊断。包括内镜检查、动态反流监测和高分辨率测压在内的诊断方法，在确诊GERD及指导个体化治疗方面发挥着关键作用。管理策略包括生活方式改变、使用抗分泌药物进行药物治疗以及使用藻酸盐和巴氯芬等辅助治疗。对于难治性病例，手术和内镜干预可提供持久的症状缓解。GERD的并发症可能是食管性的或食管外的，这凸显了早期诊断和有效管理的重要性。尽管难治性病例需要针对诸如肠-脑相互作用障碍和行为障碍等重叠情况采取定制方法，但GERD经适当治疗后的预后总体良好。多学科、以患者为中心的方法可优化治疗效果并改善GERD患者的生活质量。本综述全面概述了目前对GERD的认识，重点关注临床表现、诊断策略和治疗选择。
