ABSTRACT

Introduction: Esophagus dysmotility is a crucial risk factor of gastroesophageal reflux disease (GERD), which is one of the most common diseases in digestive medicine globally. This review emphasizes the mechanisms of esophagus dysmotility in diabetes and summarizes more targeted treatments for these patients to avoid the overuse of proton pump inhibitors (PPIs).

Areas covered: Diabetes mellitus (DM) is a clear factor that must not be neglected in the development of GERD. Previous studies have preliminarily researched the esophagus deterioration in diabetes. However, the multi-faceted mechanisms of esophagus dysmotility in diabetes need more studies. Besides, targeted treatments for these patients rather than conventional PPIs are urgently needed.

Expert opinion: The treatments for GERD patients with diabetes should be further explored. Pharmacological approaches such as prokinetic agents, psychotherapy can be adopted. Meanwhile, it's feasible to explore non-drug treatments. For example, Electroacupuncture (EA) at Zusanli (ST-36) may be effective to protect the networks of intestinal cells of Cajal (ICCs) in diabetes. More effective approaches should be explored to achieve individualized treatment for these patients.

摘要

简介: 食管动力障碍是胃食管反流病（GERD）的重要危险因素，胃食管反流病是全球消化医学中最常见的疾病之一。本综述强调了糖尿病患者食管动力障碍的机制，并总结了针对这些患者的更有针对性的治疗，以避免过度使用质子泵抑制剂 (PPI)。

涵盖的领域： 糖尿病 (DM) 是 GERD 发展过程中不容忽视的一个明显因素。以往的研究已经初步研究了糖尿病患者的食道恶化。然而，糖尿病食管动力障碍的多方面机制需要更多的研究。此外，迫切需要针对这些患者的靶向治疗，而不是传统的 PPI。

专家意见：GERD合并糖尿病患者的治疗方法有待进一步探索。可以采用促动力剂、心理治疗等药理学方法。同时，探索非药物治疗也是可行的。例如，足三里 (ST-36) 的电针 (EA) 可能有效保护糖尿病患者的 Cajal (ICC) 肠细胞网络。应该探索更有效的方法来实现对这些患者的个体化治疗。