概述

胃食管反流病是指胃酸反复倒流至连接口腔和胃的管道(即食管)的一种状况。常常简称为 GERD。这种倒流称为胃酸反流,会刺激食管内膜。

许多人都会偶尔出现胃酸反流。但在一段时间内反复发生胃酸反流会导致 GERD。

大多数人可以通过改变生活方式和使用药物来管理 GERD 引起的不适。有些人可能需要通过手术来缓解症状,但这种情况不常见。

症状

GERD 的常见症状包括:

  • 胸部灼热感,通常称为胃灼热。胃灼热通常发生在进食后,夜间或平躺时可能加重。
  • 食物或酸性液体反流至咽喉。
  • 上腹部或胸部疼痛。
  • 难以吞咽(即吞咽困难)。
  • 咽喉中有肿块感。

如果您有夜间胃酸反流,可能还会出现:

  • 持续咳嗽。
  • 声带发炎(即喉炎)。
  • 哮喘新发或加重。

何时就诊

如果您有胸部疼痛,尤其如果还出现气短或者颚部或手臂疼痛,请立即就医。这些可能是心脏病发作的症状。

如果您出现以下情况,请与医务人员约诊:

  • 出现严重或频繁的 GERD 症状。
  • 每周服用两次以上治疗胃灼热的非处方药。

病因

GERD 由胃酸或非酸性胃内容物频繁反流所引起。

吞咽时,食管底部(称为食管下括约肌)周围的环形肌肉带松弛,让食物和液体流入胃部。然后,括约肌再次闭合。

如果括约肌无法正常松弛或变弱,胃酸可能回流到食管。持续的胃酸反流会刺激食管内膜,从而经常导致发炎。

风险因素

可增加患 GERD 风险的状况包括:

  • 肥胖症。
  • 胃顶部隆起到横膈膜上方(即食管裂孔疝)。
  • 怀孕。
  • 结缔组织病,如硬皮病。
  • 胃排空延迟。

可加重胃酸反流的因素包括:

  • 抽烟。
  • 暴食或深夜进食。
  • 食用某些食物,如高脂或油炸食物。
  • 饮用某些饮料,如酒或咖啡。
  • 服用某些药物,如阿司匹林。

并发症

Over time, long-lasting inflammation in the esophagus can cause:

  • Inflammation of the tissue in the esophagus, known as esophagitis. Stomach acid can break down tissue in the esophagus. This can cause inflammation, bleeding and sometimes an open sore, called an ulcer. Esophagitis can cause pain and make swallowing difficult.
  • Narrowing of the esophagus, called an esophageal stricture. Damage to the lower esophagus from stomach acid causes scar tissue to form. The scar tissue narrows the food pathway, leading to problems with swallowing.
  • Precancerous changes to the esophagus, known as Barrett esophagus. Damage from acid can cause changes in the tissue lining the lower esophagus. These changes are associated with an increased risk of esophageal cancer.

Aug. 22, 2024
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