Lukás K
II. interní klinika VFN a 1. LF UK, Praha.
Cas Lek Cesk. 1997 May 29;136(11):337-42.
Reflux disease is a very frequent condition; its most frequent symptom, pyrosis, is found daily in 7% of the population. The disease is dut to the aggressive action of the gastroesophageal reflux "faced" by defensive oesophageal mechanisms. Reflux disease is classified as endoscopically positive with an obvious finding of oesophagitis and endoscopically negative with a normal endoscopic finding but detectable histological changes. Complications of the disease include strictures, ulcers, haemorrhage and Barrett's oesophagus. In the therapeutic regime provisions are used, medicamentous treatment (antacids, sucralphate, prokinetics, antagonists of H2 receptors and proton pump inhibitors) and surgical treatment. In the therapeutic strategy two procedures are possible: 1. the method of choice (treatment with a single drug) and 2. stepwise therapy a) step-up-the basis are regime provisions and gradually drugs are added, b) step-down-treatment is started with the most effective drug, the proton pump inhibitor, and is reduced gradually). Treatment has a short-term character (treatment of the acute attack) and long-term (maintenance treatment). Contemporary therapeutic possibilities improve the prognosis of the disease and the quality of life of patients with reflux disease to the quality level of the normal population.
反流性疾病是一种非常常见的病症；其最常见的症状——烧心，在7%的人群中每天都会出现。该疾病是由于食管防御机制所“面对”的胃食管反流的侵袭性作用所致。反流性疾病根据内镜检查结果分为内镜阳性（有明显的食管炎表现）和内镜阴性（内镜检查结果正常但有可检测到的组织学改变）。该疾病的并发症包括狭窄、溃疡、出血和巴雷特食管。在治疗方案中，采用药物治疗（抗酸剂、硫糖铝、促动力药、H2受体拮抗剂和质子泵抑制剂）和手术治疗。在治疗策略上有两种方法可行：1. 首选方法（单一药物治疗）和2. 逐步治疗：a) 逐步升级——以治疗方案为基础，逐渐添加药物；b) 逐步降级——从最有效的药物质子泵抑制剂开始治疗，然后逐渐减量。治疗具有短期（急性发作的治疗）和长期（维持治疗）的特点。当代的治疗方法改善了该疾病的预后以及反流性疾病患者的生活质量，使其达到正常人群的质量水平。
