Gastroesophageal reflux disease
Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- heartburn
- acid regurgitation
Otros factores de diagnóstico
- dysphagia
- bloating/early satiety
- laryngitis
- globus
- enamel erosion
- halitosis
- dyspepsia
Factores de riesgo
- family history of heartburn or GERD
- older age
- hiatal hernia
- obesity
- use of lower esophageal sphincter (LES) tone-reducing drugs
- psychological stress
- asthma
- use of nonsteroidal anti-inflammatory drugs (NSAIDs)
- smoking
- alcohol consumption
- peroral endoscopic myotomy (POEM)
- dietary factors
- pregnancy
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- proton-pump inhibitor (PPI) trial
Pruebas diagnósticas que deben considerarse
- esophagogastroduodenoscopy (EGD)
- ambulatory pH monitoring
- esophageal manometry
- combined impedance-pH testing
- barium swallow
- esophageal capsule endoscopy
Pruebas emergentes
- endolumenal functional lumen imaging probe
Algoritmo de tratamiento
initial presentation
nonpregnant: proton-pump inhibitor-responsive
nonpregnant: incomplete response to proton-pump inhibitor
pregnant: intractable symptoms or complicated reflux disease
Colaboradores
Autores
Marc J. Zuckerman, MD
Professor of Medicine
Chief of Division of Gastroenterology
Texas Tech University Health Sciences Center
El Paso
TX
Divulgaciones
MJZ has been reimbursed and is on the speakers bureau for Phathom Pharmaceuticals, the manufacturer of vonoprazan.
Andres F. Carrion, MD
Gastroenterologist
GastroMed Miami
Miami
FL
Divulgaciones
AFC declares that he has no competing interests.
Agradecimientos
Dr Marc J. Zuckerman and Dr Andres F. Carrion would like to gratefully acknowledge Dr Sheila Feit and Dr Mohamed Othman, previous contributors to this topic.
Divulgaciones
SF declares that she has no competing interests. MO has acted as a consultant for Olympus.
Revisores por pares
Lars Aabakken, MD
Professor of Medicine
Chief of GI Endoscopy
Rikshospitalet University Hospital
Oslo
Norway
Divulgaciones
LA declares that he has no competing interests.
Lise Lotte Gluud, MD, DMSc
Consultant
Department of Internal Medicine
Copenhagen University Hospital
Hellerup
Denmark
Divulgaciones
LLG declares that she has no competing interests.
Gary W. Falk, MD, MS
Professor of Medicine
Department of Gastroenterology & Hepatology
Center for Swallowing & Esophageal Disorders
Cleveland Clinic
Cleveland
OH
Divulgaciones
GWF has received fees from: AstraZeneca (consultant, speakers bureau, grant support); Takeda (grant support); Pentax (speaker, travel); Wyeth (consultant); and C2 Therapeutics (consultant).
Agradecimiento de los revisores por pares
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Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
Katz PO, Dunbar KB, Schnoll-Sussman FH, et al. ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2022 Jan 1;117(1):27-56.Texto completo Resumen
ASGE Standards of Practice Committee, Desai M, Ruan W, et al. American Society for Gastrointestinal Endoscopy guideline on the diagnosis and management of GERD: summary and recommendations. Gastrointest Endosc. 2025 Feb;101(2):267-84.Texto completo Resumen
Freedberg DE, Kim LS, Yang YX. The risks and benefits of long-term use of proton pump inhibitors: expert review and best practice advice from the American Gastroenterological Association. Gastroenterology. 2017 Mar;152(4):706-15. Resumen
Ness-Jensen E, Hveem K, El-Serag H, et al. Lifestyle intervention in gastroesophageal reflux disease. Clin Gastroenterol Hepatol. 2016 Feb;14(2):175-82.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
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Más DiferencialesGuías de práctica clínica
- Guideline on the diagnosis and management of GERD: summary and recommendations
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Más Guías de práctica clínicaFolletos para el paciente
GERD: questions to ask your doctor
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