胃食管反流病

最后审阅: 3 九月 2022
最后更新: 20 四月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 烧心
  • 反酸
更多 关键诊断因素

其他诊断因素

  • 吞咽困难
  • 腹胀/早饱
  • 喉炎
  • 异物感
  • 牙釉质腐蚀
  • 口臭
  • 消化不良
其他诊断因素

危险因素

  • 烧心或 GORD 家族史
  • 老年
  • 食管裂孔疝
  • 肥胖
  • 降低食管下括约肌压力的药物
  • 心理应激
  • 哮喘
  • 非甾体抗炎药 (NSAID)
  • 吸烟
  • 饮酒
  • 经口内镜下肌切开术(Per-oral Endoscopic Myotomy, POEM)
  • 饮食因素
更多 危险因素

诊断性检查

首要检查

  • 质子泵抑制剂试验
更多 首要检查

需考虑的检查

  • 食管胃十二指肠镜检查 (OGD)
  • 动态 pH 值监测。
  • 食管压力测定
  • 联合的阻抗 pH 检测
  • 钡餐
  • 食管胶囊内镜检查
更多 需考虑的检查

新兴检查

  • 腔内功能性管腔成像探头

治疗流程

急症处理

初期表现

持续性治疗

质子泵抑制剂敏感

对质子泵抑制剂不完全敏感

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 has been a speaker for Salix Pharmaceuticals. Allergan Pharmaceuticals, Takeda Pharmaceuticals, and is a consultant for Intercept Pharmaceuticals. He is an author of a reference cited in this topic.

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: Astra Zeneca (consultant, speakers bureau, grant support); Takeda (grant support); Pentax (speaker, travel); Wyeth (consultant); and C2 Therapeutics (consultant).

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  • 鉴别诊断

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