Avtor/Urednik		Tepeš, Bojan
Naslov		Gastroezofagealna refluksna bolezen
Prevedeni naslov		Gastroesophageal reflux disease
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 43, št. 3
Leto izdaje		2004
Obseg		str. 261-77
Jezik		slo
Abstrakt		The prevalence of gastroesophageal reflux disease in the Western world is rising and is now up to 20%. The main etiological factors are an incompetent anti reflux barrier and/or unsuccessful luminal clearance mechanisms. Gastroesophageal reflux disease can be divided into three groups: 70% of patients have the non-erosive form, 30% the erosive form, and 70% of former patients with the erosive form also have complications. Heartburn and acid regurgitation are typical symptoms oft he disease. Atypical symptoms are caused by acid microaspiration or vasovagal reflex mechanisms, and are as follows: water brash, dysphagia, odynophagia, chronic cough, noncardiac chest pain, bronchial asthma and teeth erosion. Testing with a proton pump inhibitor, upper gastroiniestinal endoscopy, continuous ambulatory pH monitoring and esophageal monometry are the most widely used diagnostic tests. Proton pump inhibitors are the drug of choice in the therapy of gastroesophageal reflux disease. Patients are also advised on lifestyle modifications. 80% of the patients will experience a relapse within a year of stopping medical therapy. The long term management of gastroesophageal reflux disease is comprised of on-demand therapy with a proton pump inhibitor or permanent therapy with the same drug. The possibilities for surgical treatment are also described, as well as principles of cancer surveillance in patients with Barrett's esophagus.
Izvleček		Razširjenost gastroezofagealne refluksne bolezni v razvitem svetu narašča in dosega že do 20% prebivalstva. Vzrok za njen nastanek je neuspešnost protirefluksnih mehanizmov in/ali neuspešnost čistilnih mehanizmov požiralnika. Bolezen delimo v tri skupine: neerozivno obliko, ki jo ima skoraj 70% bolnikov; erozivno obliko, ki jo ima 30% bolnikov, in erozivno obliko z zapleti, ki jo ima do 10% bolnikov z erozivno obliko. Značilna simptoma bolezni sta zgaga in vračanje kisline v požiralnik. Bolniki z gastroezofagealno refluksno boleznijo pa lahko imajo tudi simptome zunaj požiralnika, t, i. netipične simptome, ki so posledica aspiracije manjše količine kisline ali pa vazovagalnih refleksov. Mednje sodijo pojačano slinjenje, disfagija, odinofagija, kronični kašelj, nesrčna prsna bolečina, poslabšanje bronhialne astme in okvara zobne sklenine. V diagnostičnem postopku uporabljamo test z zaviralcem protonske črpalke, ezofagogastroduodenoskopijo, 24-urno pH-metrijo in manometrijo. Gastroezofagealno bolezen zdravimo z dietnimi priporočili in dolgotrajno uporabo zaviralca protonske črpalke. Leto dni po zdravljenju pride do ponovitve bolezni pri 80% bolnikov. Zato nekatere bolnike zdravimo z zaviralci protonske črpalke po potrebi, nekateri pa morajo enaka zdravila jemati trajno. Prikazane so tudi možnosti kirurškega zdravljenja in načela sledenja bolnikov z Barrettovim požiralnikom.
Deskriptorji		GASTROESOPHAGEAL REFLUX HEARTBURN ESOPHAGITIS, PEPTIC DEGLUTITION DISORDERS BARRETT ESOPHAGUS COUGH HOARSENESS ENDOSCOPY, DIGESTIVE SYSTEM MANOMETRY HYDROGEN-ION CONCENTRATION ANTACIDS