PDF(Pubmed)
Abstract：
UNASSIGNED: Gastroesophageal reflux (GER) disease (GERD) is a condition wherein GER causes troublesome symptoms that can affect daily functioning and/or clinical complications within the esophagus or other systems. To avoid this, patients with GERD often require treatment; hence, it is important to distinguish GER from GERD. Patients with GERD exhibiting alarm signs should be examined early to differentiate it from GER and treated accordingly. Herein, we present a case of GERD caused by a hiatal hernia that required surgical intervention for esophagial cicatrical stenosis despite oral treatment. We also discussed how to choose the appropriate acid suppressants for GERD.
UNASSIGNED: A 1-year-old boy was referred to our hospital for repeated vomiting and poor weight gain. He received histamine 2 receptor antagonists (H2RAs) that contributed slightly to the decreased frequency of vomiting and aided weight gain; however, he soon stopped gaining weight and had bloody vomit. His upper gastrointestinal series revealed hiatal hernia, a 24 h impedance pH monitoring test indicated abnormal values for acid reflux, and esophagogastroduodenoscopy (EGD) revealed esophagitis. He was subsequently diagnosed with GERD associated with hiatal hernia. A proton pump inhibitor (PPI) was intravenously administered to him, following which his medication was changed to a potassium-competitive acid blocker (P-CAB). Thereafter, his vomiting episodes significantly decreased and his weight increased. However, 6 months after starting P-CAB, his vomiting episodes suddenly increased in frequency. EGD revealed the presence esophageal stricture due to scarring from GERD. He was then treated via laparoscopic fundoplication, gastrostomy, and esophageal balloon dilation. Thereafter, his vomiting episodes stopped and food intake improved, leading to weight gain.
UNASSIGNED: It is essential to identify the cause of GERD early and take an appropriate treatment approach depending on the cause of GERD with alarm signs. Further, as a drug therapy for GERD as a clear acid mediated disease or in children with alarm signs, PPIs or P-CAB should be used from the beginning instead of H2RAs.
UNASSIGNED: A 1-year-old boy was referred to our hospital for repeated vomiting and poor weight gain. He received histamine 2 receptor antagonists (H2RAs) that contributed slightly to the decreased frequency of vomiting and aided weight gain; however, he soon stopped gaining weight and had bloody vomit. His upper gastrointestinal series revealed hiatal hernia, a 24 h impedance pH monitoring test indicated abnormal values for acid reflux, and esophagogastroduodenoscopy (EGD) revealed esophagitis. He was subsequently diagnosed with GERD associated with hiatal hernia. A proton pump inhibitor (PPI) was intravenously administered to him, following which his medication was changed to a potassium-competitive acid blocker (P-CAB). Thereafter, his vomiting episodes significantly decreased and his weight increased. However, 6 months after starting P-CAB, his vomiting episodes suddenly increased in frequency. EGD revealed the presence esophageal stricture due to scarring from GERD. He was then treated via laparoscopic fundoplication, gastrostomy, and esophageal balloon dilation. Thereafter, his vomiting episodes stopped and food intake improved, leading to weight gain.
UNASSIGNED: It is essential to identify the cause of GERD early and take an appropriate treatment approach depending on the cause of GERD with alarm signs. Further, as a drug therapy for GERD as a clear acid mediated disease or in children with alarm signs, PPIs or P-CAB should be used from the beginning instead of H2RAs.
摘要：
胃食管反流（GER）疾病（GERD）是一种疾病，其中GER引起麻烦的症状，可以影响食道或其他系统内的日常功能和/或临床并发症。为了避免这种情况,GERD患者通常需要治疗；因此，区分GER和GERD很重要。应及早检查表现出警报体征的GERD患者，以将其与GER区分开，并进行相应的治疗。在这里，我们介绍了一例食管裂孔疝引起的GERD病例,尽管进行了口服治疗,但仍需要手术治疗食管瘢痕狭窄.我们还讨论了如何选择适合GERD的酸抑制剂。
■一名1岁男孩因反复呕吐和体重增加不良而被转诊到我们医院。他接受了组胺2受体拮抗剂（H2RAs），这略微有助于减少呕吐频率并有助于体重增加；然而，他很快就不再发胖了，吐了血。他的上消化道系列显示食管裂孔疝，24小时阻抗pH监测试验表明酸回流值异常，食管胃十二指肠镜（EGD）显示食管炎。随后，他被诊断出患有食管裂孔疝相关的GERD。他静脉注射质子泵抑制剂（PPI），随后他的药物被改为钾竞争性酸阻滞剂(P-CAB).此后,他的呕吐次数明显减少，体重增加。然而,开始P-CAB后6个月，他的呕吐发作频率突然增加。EGD显示存在因GERD瘢痕引起的食管狭窄。然后他通过腹腔镜胃底折叠术治疗，胃造口术,食道球囊扩张术.此后,他的呕吐发作停止，食物摄入量改善，导致体重增加。
■必须尽早确定GERD的病因，并根据具有警报体征的GERD的病因采取适当的治疗方法。Further,作为GERD的药物治疗，作为一种明确的酸介导的疾病或儿童的报警迹象，应该从一开始就使用PPI或P-CAB，而不是H2RA。
■一名1岁男孩因反复呕吐和体重增加不良而被转诊到我们医院。他接受了组胺2受体拮抗剂（H2RAs），这略微有助于减少呕吐频率并有助于体重增加；然而，他很快就不再发胖了，吐了血。他的上消化道系列显示食管裂孔疝，24小时阻抗pH监测试验表明酸回流值异常，食管胃十二指肠镜（EGD）显示食管炎。随后，他被诊断出患有食管裂孔疝相关的GERD。他静脉注射质子泵抑制剂（PPI），随后他的药物被改为钾竞争性酸阻滞剂(P-CAB).此后,他的呕吐次数明显减少，体重增加。然而,开始P-CAB后6个月，他的呕吐发作频率突然增加。EGD显示存在因GERD瘢痕引起的食管狭窄。然后他通过腹腔镜胃底折叠术治疗，胃造口术,食道球囊扩张术.此后,他的呕吐发作停止，食物摄入量改善，导致体重增加。
■必须尽早确定GERD的病因，并根据具有警报体征的GERD的病因采取适当的治疗方法。Further,作为GERD的药物治疗，作为一种明确的酸介导的疾病或儿童的报警迹象，应该从一开始就使用PPI或P-CAB，而不是H2RA。
