Pathophysiology and treatment options for gastroesophageal reflux disease: looking beyond acid,Annals of the New York Academy of Sciences

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Pathophysiology and treatment options for gastroesophageal reflux disease: looking beyond acid
Annals of the New York Academy of Sciences ( IF 4.1 ) Pub Date : 2020-10-04 , DOI: 10.1111/nyas.14501
Priya Sharma ₁ , Rena Yadlapati ₂

Affiliation

Gastroesophageal reflux disease (GERD) is a disorder due to the retrograde flow of refluxate into the esophagus. Although GERD is a common clinical diagnosis, its pathogenesis is quite complex. As a result of its multifactorial development, many patients continue to experience adverse symptoms due to GERD despite prolonged acid suppression with proton pump inhibitor therapy. The pathogenesis of GERD involves an interplay of chemical, mechanical, psychologic, and neurologic mechanisms, which contribute to symptom presentation, diagnosis, and treatment. As such, GERD should be approached as a disorder beyond acid. This review will investigate the major factors that contribute to the development of GERD, including factors related to the refluxate, esophageal defenses, and factors that promote pathologic reflux into the esophagus. In reviewing GERD pathogenesis, this paper will highlight therapeutic advances, with mention of future opportunities of study when approaching GERD.

中文翻译：

胃食管反流病的病理生理学和治疗选择：超越酸

胃食管反流病 (GERD) 是一种由于反流液逆行流入食管而引起的疾病。虽然GERD是一种常见的临床诊断，但其发病机制相当复杂。由于其多因素发展，尽管质子泵抑制剂治疗延长了胃酸抑制时间，但许多患者仍会因 GERD 而出现不良症状。GERD 的发病机制涉及化学、机械、心理和神经机制的相互作用，这些机制有助于症状表现、诊断和治疗。因此，GERD 应该被视为酸以外的一种疾病。这篇综述将调查促成 GERD 发展的主要因素，包括与反流、食管防御相关的因素，以及促进病理性反流进入食管的因素。

更新日期：2020-10-04

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