Resumo
Definição
病史和体格检查
关键诊断因素
- heartburn
- acid regurgitation
其他诊断因素
- dysphagia
- bloating/early satiety
- laryngitis
- globus
- enamel erosion
- halitosis
- dyspepsia
危险因素
- 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
诊断性检查
首要检查
- proton-pump inhibitor (PPI) trial
需考虑的检查
- esophagogastroduodenoscopy (EGD)
- ambulatory pH monitoring
- esophageal manometry
- combined impedance-pH testing
- barium swallow
- esophageal capsule endoscopy
新兴检查
- endolumenal functional lumen imaging probe
治疗流程
initial presentation
nonpregnant: proton-pump inhibitor-responsive
nonpregnant: incomplete response to proton-pump inhibitor
pregnant: intractable symptoms or complicated reflux disease
撰稿人
作者
Marc J. Zuckerman, MD
Professor of Medicine
Chief of Division of Gastroenterology
Texas Tech University Health Sciences Center
El Paso
TX
利益声明
MJZ is on the speakers bureau for Phathom Pharmaceuticals.
Andres F. Carrion, MD
Associate Professor of Clinical Medicine
Division of Gastroenterology and Hepatology
University of Miami
Miami
FL
利益声明
AFC declares that he has no competing interests.
鸣谢
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.
利益声明
SF declares that she has no competing interests. MO has acted as a consultant for Olympus.
同行评议者
Lars Aabakken, MD
Professor of Medicine
Chief of GI Endoscopy
Rikshospitalet University Hospital
Oslo
Norway
利益声明
LA declares that he has no competing interests.
Lise Lotte Gluud, MD, DMSc
Consultant
Department of Internal Medicine
Copenhagen University Hospital
Hellerup
Denmark
利益声明
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
利益声明
GWF has received fees from: AstraZeneca (consultant, speakers bureau, grant support); Takeda (grant support); Pentax (speaker, travel); Wyeth (consultant); and C2 Therapeutics (consultant).
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
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.全文 摘要
Muthusamy VR, Lightdale JR, Acosta RD, et al; ASGE Standards of Practice Committee. The role of endoscopy in the management of GERD. Gastrointest Endosc. 2015;81(6):1305-10.全文 摘要
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. 摘要
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.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
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- Functional esophageal disorder/functional heartburn
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更多 指南患者教育信息
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