胃食管反流病

依赖临床诊断。质子泵抑制剂（PPI）的试验性治疗既有助于诊断又能够进行初始治疗。

上消化道内镜检查适合用于评估并发症；不典型、持续或复发症状；或者警示症状（例如体重下降、贫血）。

一旦停止治疗，复发率高。

严重并发症包括食管狭窄、Barrett 食管以及食管癌。

美国胃肠病学院将胃食管反流病（gastro-oesophageal reflux disease，GORD）定义为“胃内容物回流到食管或更远处，进入口腔（包括喉）或肺，从而导致症状或并发症”。[1]Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013 Mar;108(3):308-28. http://gi.org/guideline/diagnosis-and-managemen-of-gastroesophageal-reflux-disease/ http://www.ncbi.nlm.nih.gov/pubmed/23419381?tool=bestpractice.com

典型症状是烧心和反酸。食管外症状包括咳嗽、喉炎、哮喘或牙侵蚀。非典型症状包括消化不良、上腹痛、恶心、腹胀和呃逆。[1]Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013 Mar;108(3):308-28. http://gi.org/guideline/diagnosis-and-managemen-of-gastroesophageal-reflux-disease/ http://www.ncbi.nlm.nih.gov/pubmed/23419381?tool=bestpractice.com

GORD 可能伴随或不伴随食管炎症（食管炎）发生。如果在内窥镜检查时发现糜烂，则此疾病被称为糜烂性反流病（erosive reflux disease，ERD）；如果没有糜烂，则称为非糜烂性反流病（non-erosive reflux disease，NERD）。[1]Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013 Mar;108(3):308-28. http://gi.org/guideline/diagnosis-and-managemen-of-gastroesophageal-reflux-disease/ http://www.ncbi.nlm.nih.gov/pubmed/23419381?tool=bestpractice.com

美国胃肠病协会 (American Gastroenterological Association) 根据蒙特利尔标准来定义胃食管反流病。[2]Vakil N, van Zanten SV, Kahrilas P, et al. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006 Aug;101(8):1900-20. http://www.ncbi.nlm.nih.gov/pubmed/16928254?tool=bestpractice.com [3]Kahrilas PJ, Shaheen NJ, Vaezi MF, et al. American Gastroenterological Association medical position statement on the management of gastroesophageal reflux disease. Gastroenterology. 2008 Oct;135(4):1383-91. http://www.gastrojournal.org/article/S0016-5085%2808%2901606-5/fulltext http://www.ncbi.nlm.nih.gov/pubmed/18789939?tool=bestpractice.com 其定义为胃内容物反流，从而引发影响健康的不适症状或导致并发症。