リフラックス関連咳嗽の診断と管理アプローチ
Ofer Z Fass1, Rena H Yadlapati2
11Kenneth C. Griffin Esophageal Center of Northwestern Medicine, Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Gastroenterology & hepatology
|February 6, 2026
まとめ
世界的に10%に見られる慢性咳嗽は、胃食道逆流症(GERD)に関連していることが多い。リフラックス関連咳嗽の患者の多くは典型的なGERD症状を欠いているため、診断は困難である。
背景:
- 慢性咳嗽(8週間以上)は、世界人口の10%に影響を与え、生活の質を著しく低下させます。
- 胃食道逆流症(GERD)は慢性咳嗽の既知の原因ですが、そのメカニズムは複雑であり、古典的なGERD症状(胸焼け、呑酸)なしに現れることが多いです。
- メカニズムには、直接的な逆流物の刺激や迷走神経媒介性の食道気管支反射が含まれ、咳過敏症が逆流の影響を増幅します。
結論:
- リフラックス関連咳嗽の正確な診断には、さまざまな方法を統合した構造化されたアプローチが必要です。
- 効果的な管理には、個々の患者のニーズに合わせた段階的な戦略が含まれます。
- 患者の転帰を改善するためには、診断ツールと臨床ガイドラインのさらなる開発が重要です。
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