Esophageal testing: What we have so far.
Esophageal testing: What we have so far.
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DOI：
10.4291/wjgp.v7.i1.72
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发表时间：
2016-02-15
期刊：
影响因子：
--
通讯作者：
Savarino, Edoardo Vincenzo
中科院分区：
文献类型：
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作者：
de Bortoli, Nicola;Martinucci, Irene;Savarino, Edoardo Vincenzo
胃食管反流病（GERD）是一种常见的胃肠道疾病。在过去的几十年里，新技术不断发展并应用于食管的功能研究，从而提高了我们对 GERD 病理生理学的了解。高分辨率测压 (HRM) 可以更好地了解食管胃交界处的功能以及与食管裂孔疝相关的风险。此外，HRM 被发现比传统的水灌注测压法更具重现性和敏感性，可检测是否存在短暂的下食管括约肌松弛。通常在内镜检查阴性且有反流症状且对抗反流药物治疗反应不佳的患者中进行食管 24 小时 pH 测量（联合或不联合阻抗），以评估食管酸暴露和症状与反流的相关性。特别是食管24小时阻抗和pH监测可以检测酸性和非酸性反流事件。 EndoFLIP 是一项最新技术，尽管它提供了大量有关食管胃交界处的信息，但在临床实践中应用很少。未来几年，可以通过新兴的无创或微创技术来评估喉咽症状，例如唾液中的胃蛋白酶检测或咽部 pH 测量。尽管现有数据很有希望，但未来仍需要对这些技术进行研究来评估其诊断准确性和实用性。
Gastroesophageal reflux disease (GERD) is a common disorder of the gastrointestinal tract. In the last few decades, new technologies have evolved and have been applied to the functional study of the esophagus, allowing for the improvement of our knowledge of the pathophysiology of GERD. High-resolution manometry (HRM) permits greater understanding of the function of the esophagogastric junction and the risks associated with hiatal hernia. Moreover, HRM has been found to be more reproducible and sensitive than conventional water-perfused manometry to detect the presence of transient lower esophageal sphincter relaxation. Esophageal 24-h pH-metry with or without combined impedance is usually performed in patients with negative endoscopy and reflux symptoms who have a poor response to anti-reflux medical therapy to assess esophageal acid exposure and symptom-reflux correlations. In particular, esophageal 24-h impedance and pH monitoring can detect acid and non-acid reflux events. EndoFLIP is a recent technique poorly applied in clinical practice, although it provides a large amount of information about the esophagogastric junction. In the coming years, laryngopharyngeal symptoms could be evaluated with up and coming non-invasive or minimally invasive techniques, such as pepsin detection in saliva or pharyngeal pH-metry. Future studies are required of these techniques to evaluate their diagnostic accuracy and usefulness, although the available data are promising.