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首页> 外文期刊>ISRN Hypertension >Gastroesophageal Reflux Symptoms not Responding to Proton Pump Inhibitor: GERD, NERD, NARD, Esophageal Hypersensitivity or Dyspepsia?
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Gastroesophageal Reflux Symptoms not Responding to Proton Pump Inhibitor: GERD, NERD, NARD, Esophageal Hypersensitivity or Dyspepsia?

机译：对质子泵抑制剂无反应的胃食管反流症状：GERD，NERD，NARD，食管超敏反应或消化不良？

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摘要

Gastroesophageal reflux (GER) is a common gastrointestinal process that can generate symptoms of heartburn and chest pain. Proton pump inhibitors (PPIs) are the gold standard for the treatment of GER; however, a substantial group of GER patients fail to respond to PPIs. In the past, it was believed that acid reflux into the esophagus causes all, or at least the majority, of symptoms attributed to GER, with both erosive esophagitis and nonerosive outcomes. However, with modern testing techniques it has been shown that, in addition to acid reflux, the reflux of nonacid gastric and duodenal contents into the esophagus may also induce GER symptoms. It remains unknown how weakly acidic or alkaline refluxate with a pH similar to a normal diet induces GER symptoms. Esophageal hypersensitivity or functional dyspepsia with superimposed heartburn may be other mechanisms of symptom generation, often completely unrelated to GER. Detailed studies investigating the pathophysiology of esophageal hypersensitivity are not conclusive, and definitions of the various disease states may overlap and are often confusing. The authors aim to clarify the pathophysiology, definition, diagnostic techniques and medical treatment of patients with heartburn symptoms who fail PPI therapy.
机译：胃食管反流（GER）是常见的胃肠道过程，可产生胃灼热和胸痛的症状。质子泵抑制剂（PPI）是治疗GER的金标准;但是，大量的GER患者对PPI无效。在过去，据信酸反流进入食道会导致全部或至少大部分归因于GER的症状，并伴有糜烂性食管炎和非糜烂性结局。然而，利用现代测试技术已经表明，除了酸倒流之外，非酸性胃和十二指肠内容物向食道的倒流也可能诱发GER症状。仍然未知如何在弱酸性或弱碱性条件下以类似于正常饮食的pH回流引起GER症状。食管超敏反应或功能性消化不良并伴有胃灼热可能是其他症状产生的机制，通常与GER完全无关。关于食管超敏反应的病理生理学的详细研究尚无定论，并且各种疾病状态的定义可能会重叠并且常常令人困惑。作者的目的是弄清楚PPI治疗失败的胃灼热症状患者的病理生理，定义，诊断技术和药物治疗。

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