GASTROESOPHAGEAL REFLUX DISEASE: A PRACTICAL APPROACH

Autor: Gerson DOMINGUES, Joaquim Prado P de MORAES-FILHO
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Arquivos de Gastroenterologia, Vol 58, Iss 4, Pp 525-533 (2021)
Druh dokumentu: article
ISSN: 1678-4219
0004-2803
DOI: 10.1590/s0004-2803.202100000-94
Popis: ABSTRACT Gastroesophageal reflux disease (GERD) presents typical manifestations such as heartburn and/or regurgitation as well as atypical manifestations such as throat symptoms, laryngitis, hoarseness, chronic cough, asthma, and sleep alterations. There are two phenotypes of the disease: erosive GERD, when erosions are identified by upper digestive endoscopy, and non-erosive GERD, when the esophageal mucosa presents a normal endoscopic aspect. Relevant clinical findings are usually absent in the physical examination, but it should be highlighted that obesity is an important aggravating factor of reflux. The treatment is established based on clinical findings and, according to the clinical situation, on complementary exams such as upper digestive endoscopy. In dubious cases where a precise diagnosis is required, the indicated test is esophageal pHmetry or impedance-pHmetry. Clinical treatment is divided into behavioral/dietary measures and pharmacological measures. Most patients benefit from clinical treatment, but surgical treatment may be indicated in the presence of a larger hiatal hernia and complications of the disease.
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