Gastroesophageal reflux disease - from the point of view of a gastroenterologist, otolaryngologist and surgeon.

IF 1 Q3 OTORHINOLARYNGOLOGY Polish Journal of Otolaryngology Pub Date : 2021-04-30 DOI:10.5604/01.3001.0014.8478
Dariusz Jurkiewicz, Dorota Waśko-Czopnik, Wioletta Pietruszewska, Wiesław Tarnowski, Magda Barańska, Magdalena Kowalczyk, Paweł Jaworski
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Abstract

Gastrooesophageal reflux disease is the regurgitation of stomach contents into the esophagus, which causes troublesome symptoms or complications for the patient. Before starting the treatment, it is always necessary to objectively confirm gastroesophageal reflux disease, especially in correlation with ENT symptoms, as extra esophageal complications. In diagnostics, the "gold standard" is a 24-hour impedance-pH supplemented with endoscopy. Treatment without objective confirmation of the disease is not recommended, the more so that non-acid gas proximal reflux, detectable only in the MIIpH test, causes the greatest number of laryngological complications. It is important to confirm the coexistence of clinical symptoms of GERD with ESS. Considering the time of treating the disease and its consequences, it is worthwhile to be cautious and careful with the diagnosis of the disease, and the treatment should be carried out for a long time in relation to the recommendation, preferably in cooperation with an ENT specialist and gastroenterologist. The greatest therapeutic effectiveness is achieved by combining PPI with itopride while maintaining the appropriate doses of drugs and observing a sufficiently long duration of treatment, while maintaining the correct dose reduction and drug discontinuation regimen. In case of failure of pharmacological treatment, antireflux surgery should be take into consideration.

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胃食管反流病-从胃肠病学家,耳鼻喉科医生和外科医生的观点。
胃食管反流病是胃内容物反流到食道,这会给病人带来麻烦的症状或并发症。在开始治疗前,始终需要客观地确认胃食管反流疾病,特别是与耳鼻喉科症状相关的疾病,是否为额外的食管并发症。在诊断学领域,“黄金标准”是24小时阻抗- ph检查,并辅以内窥镜检查。不建议在没有客观证实疾病的情况下进行治疗,更不建议仅在MIIpH试验中检测到的非酸性气体近端反流引起最多的喉部并发症。确认GERD的临床症状是否与ESS共存是很重要的。考虑到治疗疾病的时间及其后果,对疾病的诊断是值得谨慎和小心的,治疗应该按照建议进行很长时间,最好是与耳鼻喉科专家和胃肠病学家合作。最大的治疗效果是通过将PPI与依托必利联合使用,同时保持适当的药物剂量,观察足够长的治疗持续时间,同时保持正确的减量和停药方案。在药物治疗失败的情况下,应考虑手术治疗。
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来源期刊
Polish Journal of Otolaryngology
Polish Journal of Otolaryngology OTORHINOLARYNGOLOGY-
CiteScore
1.30
自引率
16.70%
发文量
15
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