Pulmonary manifestations of gastroesophageal reflux disease
Pulmonary manifestations of gastroesophageal reflux disease
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DOI：
10.4103/1817-1737.53347
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发表时间：
2009-07-01
影响因子：
2.3
通讯作者：
Gaude, Gajanan S.
中科院分区：
文献类型：
--
作者：
Gaude, Gajanan S.
胃食道反流病(GERD)可引起、触发或加重许多肺部疾病。GERD与肺部疾病之间的生理联系在慢性咳嗽和哮喘中得到了广泛的研究。初级保健医生经常在没有胃灼热的情况下遇到GERD的食道外表现。患者可能出现涉及肺部系统的症状；非心源性胸痛；以及耳、鼻和喉咙疾病。食道的局部刺激会导致各种症状，从消化不良，如胸部不适和腹痛，到咳嗽和喘息。如果胃酸到达喉咙后部，可能会引起口腔的苦味和/或胃酸吸入肺部。这种酸可引起喉咙刺激、鼻后滴水和声音嘶哑，以及反复咳嗽、胸部充血和肺部炎症，导致哮喘和/或支气管炎/肺炎。这篇临床综述探讨了GERD肺部表现的潜在病理生理学机制。同时回顾了与GERD相关的慢性咳嗽和哮喘的相关临床资料。最后，对肺部GERD的潜在管理策略进行了讨论。
Gastroesophageal reflux disease (GERD) may cause, trigger or exacerbate many pulmonary diseases. The physiological link between GERD and pulmonary disease has been extensively studied in chronic cough and asthma. A primary care physician often encounters patients with extra esophageal manifestations of GERD in the absence of heartburn. Patients may present with symptoms involving the pulmonary system; noncardiac chest pain; and ear, nose and throat disorders. Local irritation in the esophagus can cause symptoms that vary from indigestion, like chest discomfort and abdominal pain, to coughing and wheezing. If the gastric acid reaches the back of the throat, it may cause a bitter taste in the mouth and/or aspiration of the gastric acid into the lungs. The acid can cause throat irritation, postnasal drip and hoarseness, as well as recurrent cough, chest congestion and lung inflammation leading to asthma and/or bronchitis/pneumonia. This clinical review examines the potential pathophysiological mechanisms of pulmonary manifestations of GERD. It also reviews relevant clinical information concerning GERD-related chronic cough and asthma. Finally, a potential management strategy for GERD in pulmonary patients is discussed.