[의학] 역류성 식도염(Gastroesophageal Reflux Disease)PBL(영문)
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- 2011.01.25 / 2019.12.24
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추천 연관자료
- 목차
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1.Introduction
2.Epidemiology
3.Health Care Impact
4.Pathogenesis
5.Clinical Features
6.Differential Diagnosis
7.Associated Conditions
8.Diagnosis
9.Clinical Course
10.Complications and Treatments (to be continued next week)
- 본문내용
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the decreasing prevalence of H. pylori may be playing a contributory role to the increasing prevalence of GERD in these regions
many patients with H. pylori–induced gastritis have involvement of both the antrum and corpus, decreasing parietal cell mass, reducing acid secretion, and elevating gastric pH, which may have a protective effect on the esophageal mucosa in patients susceptible to GERD
Genetic mechanisms are unknown but may be related to a smooth muscle disorder associated with hiatal hernia, reduced lower esophageal sphincter (LES) pressure, and impaired esophageal motility
Considerable morbidity and complications (such as esophageal ulcerations, peptic strictures, and Barrett's esophagus)
Heartburn is the 5th most common gastrointestinal complaint
The 2nd leading outpatient/ 7th most common inpatient gastrointestinal diagnosis
The most costly gastrointestinal disease in 2000 (the largest component was drugs)
As a chronic disease, significantly impairs quality of life
comparable to arthritis, myocardial infarction, heart failure, or hypertension
The second tier against reflux damage
Volume clearance
: actual removal of the reflux material from esophagus
Acid clearance
: restoration of normal esophageal pH with saliva and esophageal gland secretion
Classic reflux symptoms
1) Hear burn : classic Sx of GERD, occurs postprandially after large meals or after ingesting spicy food, fat and chocolate
2) Acid regurgitation : effortless regurgitation of acidic fluid, especially after meals and worsened by supine position, is highly suggestive of GERD
3) Dysphagia : usually occurs in long-standing heartburn with slowly progressive dysphagia for solid
- 참고문헌
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Chapter 42, Gastroesophageal Reflux Disease and Its Complications, Feldman: Sleisenger & Fordtran’s Gastrointestinal and Liver Disease, 8th ed., 2006 Saunders, An Imprint of Elsevier.
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