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Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring

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呈现逆流症状的患者 - - 检测谁,治疗谁?

Noy Lapidot Alon¹, Tomas Navarro Rodriguez¹, Ronnie Fass¹

¹The Esophageal and Swallowing Center, Division of Gastroenterology and Hepatology, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, USA.

The Korean journal of helicobacter and upper gastrointestinal research..

|June 23, 2025

概括

胃食道逆流性疾病 (GERD) 的管理包括在测试和经验治疗之间做出决定. 优先测试警报症状或高风险患者;否则,用质子抑制剂 (PPI) 或竞争性酸阻断剂 (PCAB) 的实证治疗通常是合适的.

科学领域:

胃肠病学胃肠病学
内部医学内部医学
临床决策 - 临床决策

背景情况:

胃食道逆流性疾病 (GERD) 呈现出各种症状,包括典型的胃灼热和食道外表现.
区分需要立即测试的患者与经验治疗之间的区别是一个临床挑战.
警报症状,耐火性疾病和巴雷特食道的危险因素需要调查.

研究的目的:

概述一种基于证据的方法来管理GERD.
引导临床医生决定何时开始诊断测试与实证治疗.
在不响应病例中提供建议,以升级治疗.

主要方法:

对GERD管理的临床指南和证据的审查.
分析患者表现,包括警报症状,并发病症和症状类型.
考虑上部内镜等诊断工具以及诸如质子抑制剂 (PPI) 和竞争性酸阻断剂 (PCAB) 等治疗选择.

主要成果:

初始检测 (例如上部内镜) 建议患者有警报症状,耐火性GERD,巴雷特食道的高风险因素,特定的并发症,或非典型/外食道症状没有典型的GERD症状.
用PPI或PCAB实证治疗适用于患有典型GERD症状而没有警报特征的患者,或与典型GERD症状一起出现食管外症状的患者.
对于最初的经验治疗没有反应的患者,建议在不立即重新测试的情况下升级到每天两次的PPI或切换到PCAB.

结论:

个性化的方法对于GERD管理至关重要,根据患者特定的因素定制决策.
临床表现应指导初始策略:首先测试或首先治疗.
优化酸抑制疗法是耐火或不响应的GERD病例的关键.

关键词:

内镜检查是指内镜检查.胃食道逆流疾病是胃食道逆流疾病.胃炎是什么意思胃炎是什么意思反流体检测是指反流体检测.吐反复出现的情况

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