胃食道逆流疾病之處置現況

The Management of Gastroesophageal Reflux Disease: An Update

廖思嘉(Szu-Chia Liao) ； 葉宏仁(Hong-Zen Yeh) ； 柯忠旺(Chung-Wang Ko) ； 連漢仲(Han-Chung Lien) ； 張繼森(Chi-Sen Chang)

《內科學誌》 21卷6期 (2010/12) Pp. 381-390

https://doi.org/10.6314/JIMT.2010.21(6).01

摘要

在世界許多國家，胃食道逆流疾病(gastroesophageal reflux disease, GERD)的發生率逐年上升，台灣也是如此，幽門桿菌感染的減少以及代謝症候群的增加是目前認爲重要的原因。胃食道逆流疾病診斷上以症狀包括心口灼熱及胃酸逆流爲主，胃鏡及24小時食道酸鹼值檢測可作爲輔助診斷的工具。隨著逆流性食道炎的增加，針對胃食道逆流疾病的治療也獲得重視，目前仍舊是以氫離子幫浦阻斷劑(proton pump inhibitor, PPI)為主要治療的藥物，至於服用多少劑量及治療期間須要多久必須視病況作調整。長期服用是否會有副作用，也值得重視。此外，長期發生胃食道逆流疾病是否導致巴雷氏食道(Barrett's esophagus)及食道腺癌的發生率因此隨之增加，是未來值得注意的重要課題。

關鍵字

胃食道逆流疾病 ； 逆流性食道炎 ； 巴雷氏食道

並列摘要

The prevalence of gastroesophageal reflux disease (GERD) has increased worldwide in recent years, which may be explained by that facts that Helicobacter pylori infection is decreasing and metabolic disorders are becoming pervasive. The diagnosis of GERD can be easily made based on typical symptoms, such as heartburn and acid regurgitation, while the pathological changes require endoscopy or ambulatory esophageal pH monitoring to confirm. Lifestyle modification and the prescription of a proton pump inhibitor (PPI) are the key points for the management of GERD; however, the optimal dosage, duration, and potential side effects of long-term PPI use remain controversial. Moreover, the relationship between long-term GERD and the risk of Barrett's esophagusassociated adenocarcinoma is elusive; these uncertainties appear to vary from country to country and thus require further longituidinal studies targeting at the Taiwanese population.

並列關鍵字

Gastroesophageal reflux disease ； Reflux esophagitis ； Barrett's esophagus