Pathophysiology and Pharmacological Treatment of Gastroesophageal Reflux Disease
Pathophysiology and Pharmacological Treatment of Gastroesophageal Reflux Disease
复制标题
胃食管反流病的病理生理学和药理学治疗
作者：
M. Storr;A. Meining;H. Allescher
胃食管反流病（GERD）是胃肠病学家实践中最常见的诊断之一。胃食管反流描述了胃内容物通过下食管括约肌（LES）到食管的逆行运动。这是一种常见的正常现象，可能伴有或不伴有症状。与GERD相关的症状包括烧心、反酸、非心源性胸痛、吞咽困难、咽鼓炎、慢性咳嗽、哮喘、声音嘶哑、喉炎、慢性鼻窦炎和牙齿糜烂。用于连续监测食管pH值（24小时pH值监测）的光纤仪器和便携式设备的引入大大提高了诊断反流疾病和反流相关并发症的能力。病理性反流和GERD的发展可归因于许多因素。GERD的病理生理学包括由于LES压力降低导致的LES功能不全、短暂性下食管括约肌松弛（TLESR）和食管酸清除不足或延迟。单纯性格尔可在GERD早期通过改变生活方式和饮食习惯进行治疗。目前用于治疗GERD的各种药物包括粘膜保护物质、抗酸剂、H2阻断剂、促动力剂和质子泵抑制剂。虽然这些药物是有效的，但它们不一定通过改善食管清除率、增加LESP或降低TLESR的频率来影响疾病的根本原因。以下文章概述了GERD的病理生理学和药物治疗的当前概念。
Gastroesophageal reflux disease (GERD) is one of the most common diagnoses in a gastroenterologist’s practice. Gastroesophageal reflux describes the retrograde movement of gastric contents through the lower esophageal sphincter (LES) to the esophagus. It is a common, normal phenomenon which may occur with or without accompanying symptoms. Symptoms associated with GERD include heartburn, acid regurgitation, noncardiac chest pain, dysphagia, globus pharyngitis, chronic cough, asthma, hoarseness, laryngitis, chronic sinusitis and dental erosions. The introduction of fiberoptic instruments and ambulatory devices for continuous monitoring of esophageal pH (24-hour pH monitoring) has led to great improvement in the ability to diagnose reflux disease and reflux-associated complications. The development of pathological reflux and GERD can be attributed to many factors. Pathophysiology of GERD includes incompetent LES because of a decreased LES pressure, transient lower esophageal sphincter relaxations (TLESRs) and deficient or delayed esophageal acid clearance. Uncomplicated GER may be treated by modification of life style and eating habits in an early stage of GERD. The various agents currently used for treatment of GERD include mucoprotective substances, antacids, H2 blockers, prokinetics and proton pump inhibitors. Although these drugs are effective, they do not necessarily influence the underlying causes of the disease by improving the esophageal clearance, increasing the LESP or reducing the frequency of TLESRs. The following article gives an overview regarding current concepts of the pathophysiology and pharmacological treatment of GERD.
影响因子：
5.7
作者：
vanPinxteren,Bart;Numans,MattijsE;Lau,Joseph;deWit,NiekJ;Hungin,APaliS;Bonis,PeterAL
通讯作者：
Bonis,PeterAL
5-HT4受体：顽皮，但很友善。
影响因子：
13.8
作者：
Clarke,DE;Craig,DA;Fozard,JR
通讯作者：
Fozard,JR
影响因子：
158.5
作者：
Lagergren, J;Bergström, R;Nyrén, O
通讯作者：
Nyrén, O