期刊
13TH OESO WORLD CONFERENCE: THE ESOPHAGIOME I
卷 1380, 期 -, 页码 218-229出版社
BLACKWELL SCIENCE PUBL
DOI: 10.1111/nyas.13169
关键词
heartburn; multichannel impedance and pH monitoring; proton pump inhibitors; GERD; NERD; weakly acidic reflux
Nonerosive reflux disease(NERD) is a commoncondition and themost frequentphenotype of gastroesophageal reflux disease (GERD). NERD is extremely heterogeneous and includes patients with negative endoscopy but abnormal esophageal acid exposure and/or positive reflux-symptom association analysis (hypersensitive esophagus). This segregation is only possible owing to the use of impedance-pH monitoring. Indeed, weakly acidic reflux represents one of the most common causes of refractory symptoms in patients evaluated off antisecretory therapy and, more importantly, during antisecretory drug treatment. Patients with heartburn who do not have any type of reflux underlying their symptoms (functional heartburn) must be excluded from the category of GERD. The drawbacks of impedance-pH aremainly due to the day-to-day variability of the test and the fact that the accuracy of the symptomreflux correlation scores is often far fromperfect. Some histopathological characteristics, such as dilated intercellular spaces, can be helpful in distinguishing patients with NERD through esophageal biopsies. Patients with NERD in whom acid is the main pathogenetic factor respond successfully to proton pump inhibitor therapy, while those with hypersensitive esophagus to weakly acidic reflux could be treated with reflux inhibitors or surgery, although further controlled studies are required.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据