胃食管反流病研究新进展、新趋势.pdf

2015 美国消化疾病周（DDW）相关讲座--GERD 篇 主办机构：武田药品工业株式会社（TAKEDA） 会议时间：2015 年 7 月 1 日 会议地点：北京民生金融中心 C 座 4 层 1 号会议室 会场地点：北京建国门内大街 28 号 论坛主席：张樹田教授 2015 美国消化疾病周（DDW）已经顺利闭幕。 特此邀请多位参加会议的著名学者专家就会议 精华、最新研究等进行分享。 15 : 40-16：10 “胃食管反流病研究新进展、新趋势” 韩英教授 北京军区总医院 Symptomatic reflux disease The worldwide incidence of GORD and its complications is increasing along with the exponentially increasing problem of obesity. Of particular concern is the relationship between central adiposity and GORD complications, including oesophageal adenocarcinoma. Driven by progressive insight into the epidemiology and pathophysiology of GORD, the earlier belief that increased gastroesophageal reflux mainly results from one dominant mechanism has been replaced by acceptance that GORD is multifactorial. Instigating factors, such as obesity, age, genetics, pregnancy and trauma may all contribute to mechanical impairment of the oesophagogastric junction resulting in pathological reflux and accompanying syndromes. Progression of the disease by exacerbating and perpetuating factors such as obesity, neuromuscular dysfunction and oesophageal fibrosis ultimately lead to development of an overt hiatal hernia. The latter is now accepted as a central player, impacting on most mechanisms underlying gastroesophageal reflux (low sphincter pressure, transient lower oesophageal sphincter relaxation, oesophageal clearance and acid pocket position), explaining its association with more severe disease and mucosal damage. Since the introduction of proton pump inhibitors (PPI), clinical management of GORD has markedly changed, shifting the therapeutic challenge from mucosal healing to reduction of PPI-resistant symptoms. In parallel, it became clear that reflux symptoms may result from weakly acidic or non-acid reflux, insight that has triggered the search for new compounds or minimally invasive procedures to