...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Current opinion in gastroenterology >Management of gastroesophageal reflux disease that does not respond well to proton pump inhibitors.
【24h】

Management of gastroesophageal reflux disease that does not respond well to proton pump inhibitors.

机译：胃食管反流疾病的管理对质子泵抑制剂不响应。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

PURPOSE OF REVIEW: Patients with gastroesophageal reflux disease (GERD) who are not responding to proton pump inhibitors (PPIs) given once daily are very common. These therapy-resistant patients have become the new face of GERD in clinical practice in the last decade and presently pose a significant therapeutic challenge to the practicing physician. We reviewed newly accumulated information about the management of PPI failure that has been published over the past 2 years. RECENT FINDINGS: There are diverse mechanisms that contribute to the failure of PPI treatment in GERD patients and they are not limited to residual reflux. Some of the causes of PPI failure may coincide in the same patient. Upper endoscopy appears to have limited diagnostic value. In contrast, esophageal impedance with pH testing on therapy appears to provide the most insightful information about the subsequent management of these patients. Commonly, doubling the PPI dose or switching to another PPI will be offered to patients who failed PPI once daily. Failure of such therapeutic strategies is commonly followed by assessment for residual reflux. There is growing information about the potential value of compounds that can reduce transient lower esophageal sphincter relaxations. Esophageal pain modulators are commonly offered to patients with functional heartburn, although supportive clinical studies are still missing. SUMMARY: Management of refractory GERD patients remains an important clinical challenge. Recent studies have cemented the value of impedance-pH testing in pursuing proper treatment. Presently, the most promising therapeutic development for this patient population is transient lower esophageal sphincter relaxation reducers.
机译：审查目的：胃食管反流疾病（GERD）未响应每日一次的质子泵抑制剂（PPI）是非常常见的。这些抗性患者在过去十年中成为临床实践中壮观的新面孔，目前对练习医师提出了显着的治疗挑战。我们审查了关于在过去2年中发布的PPI失败管理的新累计信息。最近的发现：有不同的机制，有助于GERD患者的PPI治疗失败，它们不仅限于残留回流。 PPI失效的一些原因可能一致在同一患者中。上内窥镜检查似乎具有有限的诊断价值。相比之下，对治疗的pH值测试的食管阻抗似乎提供了关于这些患者随后的管理的最富有洞察力的信息。通常，将为PPI每天一次失败的患者提供PPI剂量或切换到另一个PPI的倍增。此类治疗策略的失败通常是随后进行残留回流的评估。有关能够降低瞬时较低食管括约肌弛豫的化合物的潜在价值的信息。虽然仍然缺少支持性临床研究，但常用于功能胃灼热患者的食管疼痛调节剂。摘要：难治性GERD患者的管理仍然是一个重要的临床挑战。最近的研究在追求适当治疗时巩固了阻抗-PH测试的价值。目前，这种患者群体的最有希望的治疗发育是短暂的食管括约肌松弛减速剂。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号