REFLUX DISEASE hebmed10胃食管反流病ppt课件.pptx

GASTROESOPHAGEAL REFLUX DISEASE;DEFINITION ;CLASSIFICATION;EPIDEMIOLOGY ;The prevalence of GERD and GERD-related disorders has been steadily increasing in the US, Western Europe, Australia and Asia. An opposing trend time was observed between 1970 and 1995 in the prevalence of peptic ulcer disease and GERD. The rates of peptic ulcer and gastric cancer fell while at the same time the rates of GERD and esophageal adenocarcinoma rose significantly.;CAUSES AND RISKS FACTORS;GERD -OBESITY;RELATIONSHIP BETWEEN HELICOBACTER PYLORI AND GERD;PATHOGENESIS;DYSFUNCTION OF THE LES ;HIATAL HERNIA;HIATAL HERNIA;PATHOGENESIS –OTHER FACTORS?;PATHOLOGY ;OTHER CAUSES OF EROSIVE ESOPHAGITIS;CLINICAL PRESENTATION-TYPICAL SYMPTOMS ;CLINICAL PRESENTATION-ATYPICAL SYMPTOMS ;CLINICAL PRESENTATION;DIAGNOSTIC METHODS;DIAGNOSTIC METHODS;UPPER ENDOSCOPY ;Allows assessment of : 24-hour esophageal acid exposure the temporal relationship between patient symptoms and acid reflux events ;TREATMENT-GOALS;LIFESTYLE MODIFICATIONS;PROTON PUMP INHIBITORS;HISTAMINE TYPE 2 RECEPTOR ANTAGONISTS;TLESR REDUCERS;PROMOTILITY AND PROKINETIC DRUGS;ANTIREFLUX SURGERY;Management algorithm;CLINICAL STRATEGIES;REFRACTORY GERD;The PPI Failure DilemmasWhat Constitutes PPI Failure?;The Reported Rate of Symptomatic Failure in Therapeutic Trials of GERD Patients; Psychological comorbidity; Psychological comorbidity;Distribution of Adherence to Proton Pump Inhibitor Treatment Over Time;Suboptimal Proton Pump Inhibitor Dosingin PPI Failure Patients; Psychological comorbidity;Terms You Need to Know;How Common is Residual Acid Reflux in Patients Who Failed PPI Once or Twice Daily? ;Results of Combined pH and Bilitec Monitoring in Symptomatic GERD Patients While on PPI Therapy;PPI once daily (2 months);EPIDEMIOLOGY