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Kan refluxsjukdom leda till komplikationer?

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Ja. Hos ungefär hälften av de patienter med refluxsjukdom som vänder sig till primärvården har återflöde av magsafter orsakat synlig skada på esofagus.

Detta tillstånd kallas refluxesofagit [9]. Upprepad skada på esofagus kan leda till utveckling av Barretts esofagus, en premalign förändring som ökar risken för adenokarcinom i esofagus.

Barretts esofagus konstateras hos en av tio symtomatiska patienter med refluxsjukdom [9]. Det går emellertid inte att identifera vilka patienter som har esofagit eller Barretts esofagus enbart genom att titta på symtomens svårighetsgrad [10].

Diagram: No correlation between GERD symptom severity and endoscopic findings

Referenser:

  1. Vakil N, Van Zanten SV, Kahrilas P, Dent J, Jones R and the Global Consensus Group. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol 2006;101:1900–20.
  2. Lundell LR, Dent J, Bennett JR, Blum AL, Armstrong D, Galmiche JP et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut 1999;45:172–80.
  3. Dent J, Brun J, Fendrick A, Fennerty M, Janssens J, Kahrilas P et al. on behalf of the Genval Workshop Group. An evidence-based appraisal of reflux disease management – the Genval Workshop Report. Gut 1999;44 Suppl 2:S1–S15.
  4. Zongli Zheng, Helena Nordenstedt, Nancy L Pedersen, Jesper Lagergren, Weimin Ye. Lifestyle factors and risk for symptomatic gastroesophageal reflux in monozygotic twins. Gastroenterology. 2007;132:87-95.
  5. Hungin AP, Raghunath AS, Wiklund I. Beyond heartburn: a systematic review of the extra-oesophageal spectrum of reflux-induced disease. Fam Pract 2005;22:591–603.
  6. Dent J, El-Serag HB, Wallander M-A, Johansson S. Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut 2005;54:710–17.
  7. Locke GR, Talley NJ, Fett SL, Zinsmeister AR, Melton JM III. Prevalence and clinical spectrum of gastroesophageal reflux: a population-based study in Olmsted County, Minnesota. Gastroenterology 1997;112:1448–56.
  8. Crawley JA, Schmitt CM. How satisfied are chronic heartburn sufferers with their prescription medications? Results of the Patient Unmet Needs Survey. J Clin Outcomes Man 2000;7:29–34.
  9. Malfertheiner P, Hallerbäck B. Clinical manifestations and complications of gastroesophageal reflux disease (GERD) Int J Clin Pract 2005;59:346–55.
  10. Kulig M, Nocon M, Vieth M, Leodolter A, Jaspersen, D Labenz J et al. Risk factors of gastroesophageal reflux disease:methodology and first epidemiological results of the ProGERD study. J Clin Epidemiol 2004;57:580–9.
  11. Dent J, Armstrong D, Delaney B, Moayyedi P, Talley NJ, Vakil N. Symptom evaluation in reflux disease: workshop background, processes, terminology, recommendations and discussion outputs. Gut 2004;53 (Suppl IV):iv1–iv24.
  12. Liker H, Hungin P, Wiklund I. Managing gastroesophageal reflux disease in primary care: the patient perspective. J Am Board Fam Pract 2005;18:393–400.
  13. Berstad A. A modified haemoglobin substrate method for the estimation of pepsin in gastric juice. Scand J Gastroenterol 1970;5:343–8.
  14. Joelsson B, Johnsson F. Heartburn – the acid test. Gut 1989;30:1523–5.
  15. Bell NJ, Burget D, Howden CW, Wilkinson J, Hunt RH. Appropriate acid suppression for the management of gastro-oesophageal reflux disease. Digestion 1992;51 Suppl 1:59–67.
  16. Carlsson R, Dent J, Watts R, Riley S, Sheikh R, Hatlebakk J et al. Gastro-oesophageal reflux disease in primary care: an international study of different treatment strategies with omeprazole. Eur J Gastroenterol Hepatol 1998;10:119–24.
  17. Kulig M, Leodolter A, Vieth M, Schulte E, Jaspersen D, Labenz J et al. Quality of life in relation to symptoms in patients with gastro-oesophageal reflux disease – and analysis based on the ProGERD initiative. Aliment Pharmacol Ther 2003;18:767–76.
  18. Johnson DA, Orr WC, Crawley JA, Traxler B, McCullough J, Brown KA et al. Effect of esomeprazole on nighttime heartburn and sleep quality in patients with GERD: a randomized, placebo-controlled trial. Am J Gastroenterol 2005;100:1914–22.
  19. Dent J et al. Scand. J. Gastro. 2008,

Senast uppdaterad: 2009-04-01

 
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