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Doença do refluxo gastroesofágico

  • Visão geral
  • Teoria
  • Diagnóstico
  • Tratamento
  • ACOMPANHAMENTO
  • Recursos
Última revisão: 13 Aug 2025
Última atualização: 28 Jan 2025

Resumo

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • presença de fatores de risco
  • pirose
  • regurgitação ácida
Полная информация

Другие диагностические факторы

  • disfagia
  • distensão abdominal/saciedade precoce
  • laringite
  • globus
  • erosão do esmalte
  • halitose
  • dispepsia
Полная информация

Факторы риска

  • história familiar de pirose ou DRGE
  • idade avançada
  • hérnia de hiato
  • obesidade
  • uso de medicamentos redutores do tônus do esfíncter esofágico inferior (EEI)
  • estresse psicológico
  • asma
  • uso de anti-inflamatórios não esteroidais (AINEs)
  • tabagismo
  • consumo de bebidas alcoólicas
  • miotomia endoscópica peroral (POEM)
  • fatores alimentares
  • gestação
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • teste do inibidor da bomba de prótons (IBP)
Полная информация

Исследования, проведение которых нужно рассмотреть

  • endoscopia digestiva alta (EDA)
  • pH-metria (monitoramento do potencial hidrogeniônico [pH]) ambulatorial
  • manometria esofágica
  • teste combinado de pHmetria com impedância
  • esofagografia baritada
  • endoscopia por cápsula esofágica
Полная информация

Неотложные исследования

  • sonda de imagem do lúmen funcional endoluminal

Алгоритм лечения

Острый

apresentação inicial

ПРОДОЛЖЕНИЕ

não gestante: com resposta clínica a inibidor da bomba de prótons

não gestante: resposta incompleta a inibidor da bomba de prótons

gestante: sintomas não tratáveis ou doença do refluxo complicada

Составители

Авторы

Marc J. Zuckerman, MD

Professor of Medicine

Chief of Division of Gastroenterology

Texas Tech University Health Sciences Center

El Paso

TX

Раскрытие информации

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

Раскрытие информации

AFC declares that he has no competing interests.

Выражение благодарностей

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.

Раскрытие информации

SF declares that she has no competing interests. MO has acted as a consultant for Olympus.

Рецензенты

Lars Aabakken, MD

Professor of Medicine

Chief of GI Endoscopy

Rikshospitalet University Hospital

Oslo

Norway

Раскрытие информации

LA declares that he has no competing interests.

Lise Lotte Gluud, MD, DMSc

Consultant

Department of Internal Medicine

Copenhagen University Hospital

Hellerup

Denmark

Раскрытие информации

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

Раскрытие информации

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.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

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.Полный текст  Аннотация

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.Полный текст  Аннотация

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. Аннотация

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.Полный текст  Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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