A 45-year-old woman, with a body mass index of 41.8 kg/m2 and a medical history of anxiety-depression syndrome, had iatrogenic hypothyroidism and degenerative osteoarticular pathology of the spinal column and complained of a burning sensation behind the sternum associated with an acidic taste in her mouth. Symptoms had appeared 3 months previously and were especially prevalent when lying down, following large meals or after drinking coffee. The patient had started to experience symptoms on most days approximately 1 month earlier. Upper digestive endoscopy (UDE) revealed isolated erosions of the distal third of the oesophagus, compatible with a diagnosis of erosive reflux oesophagitis. Lifestyle changes were recommended and 8 weeks' treatment with pantoprazole 40 mg/day taken 15-30 minutes before breakfast was prescribed. Follow-up UDE showed resolution of oesophageal lesions with no pathological changes of the mucosa. Mild regurgitation and pyrosis persisted; therefore the patient continued to receive pantoprazole 40 mg for a further 3 weeks.
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机译：一名45岁的妇女，体重指数为41.8 kg / m2，有焦虑抑郁综合症的病史，患有医源性甲状腺功能减退症和脊柱退行性骨关节炎，并抱怨与之相关的胸骨后有灼热感她嘴里的酸味。症状在3个月前出现，在躺下，大餐后或喝咖啡后尤为普遍。患者在大约1个月前的大多数天开始出现症状。上消化道内窥镜检查（UDE）显示食管远端三分之一的孤立性糜烂，与糜烂性反流性食管炎的诊断相符。建议改变生活方式，并在开早餐前15-30分钟用pan托拉唑40 mg /天治疗8周。随访的UDE显示食管病变得以解决，粘膜无病理改变。轻度返流和发热仍持续;因此，患者继续接受40 mg pan托拉唑治疗3周。
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