由于免疫和感染失调而导致食道功能障碍的AGA临床实践更新:专家评论
Chanakyaram A Reddy1, Emily McGowan2, Rena Yadlapati3
1Center for Esophageal Diseases, Division of Gastroenterology, Baylor University Medical Center, Dallas, Texas.
概括
本专家评论为诊断免疫介导和传染性食道疾病提供了最佳实践建议,强调早期识别系统性疾病,以改善患者的治疗结果并减少不必要的手术.
科学领域:
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 传染性和免疫介导的食道疾病往往被低诊断,导致食道功能障碍和医疗费用增加.
- 这些情况可能来自局部感染/免疫疾病或作为系统性疾病的表现,可能导致神经肌肉功能障碍.
- 高可疑指数对于及时诊断和有效管理至关重要.
研究的目的:
- 为免疫媒介食道疾病的诊断考虑提供最佳实践建议 (BPA).
- 为了指导临床医生评估患有失消化症,胃灼热和鼻症的患者.
- 通过集中治疗和限制不必要的程序来改善患者的治疗结果.
主要方法:
- 专家审查由美国胃肠病学协会 (AGA) 委托并批准.
- 根据对已发表文献和专家意见的审查得出的陈述.
- 内部和外部的同行评审过程.
主要成果:
- 胃肠道科医生应该识别系统免疫和传染病的食道表现.
- 当确定食道感染时,对免疫性损害的评估是必要的.
- 考虑耐火性感染,运动障碍 (例如,在性食道炎),类风湿性疾病,克罗恩氏病和皮肤病在持续或特定的食道症状.
结论:
- 意识到系统过程是诊断食道功能障碍的关键.
- 早期识别和针对传染性和免疫介导的食道疾病的向治疗可以改善患者的治疗结果.
- 考虑二次性阿喀拉西亚原因很重要,包括最近的感染和eosinophilic疾病.
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