GERD in ILD Patients
Gastroesophageal reflux disease (GERD), also known as acid reflux, 当胃内容物反流到食道时发生. 这可能是由于食道与胃交界处的肌肉变弱, called the lower esophageal sphincter, 或是食管或胃部收缩的问题.
许多研究表明反流胃食管反流与肺部疾病之间存在联系,包括 interstitial lung disease (ILD). The reason for this relationship is unclear. 一种理论认为,反流可能在某些肺部疾病的发展中发挥作用. ILD和GERD之间的联系是UCSF ILD项目中一个活跃的研究领域.
Signs and symptoms
Common signs of GERD include:
- 烧心(胸部中央有烧灼感)
- Regurgitation of food and liquid
- Acid or sour taste in the throat
- Chest pain
- Cough
Less common symptoms include stomach pain, sore throat, hoarse voice, difficult or painful swallowing, recurrent pneumonia, asthma, 慢性鼻窦感染或喉咙肿块的感觉.
Diagnosis
In the general population, 十大赌博平台排行榜通常可以通过病史和体检来诊断胃反流. In patients with ILD, diagnosis is more complicated, 因为患者可能有不寻常的症状或可能没有症状. 对于ILD患者,通常需要额外的检查来诊断GERD.
除了记录病史和做身体检查, your doctor may recommend the following tests:
- Esophageal pH monitoring. 这是测量胃酸反流频率最直接的方法. 该测试包括将一根细管插入鼻子并向下插入食道. 这根管子在里面放置24小时,测量有多少胃酸进入食道.
You can eat and drink normally during this test. 大多数患者几乎没有副作用,最常见的是喉咙痛. 检查完成后,你需要返回十大赌博平台排行榜取出输卵管. - Esophageal manometry. 通过测量食道的肌肉收缩, 这个测试可以告诉你的十大赌博平台排行榜你的下食管括约肌功能是否正常. 该测试通常与24小时pH监测器的初始放置同时进行.
- Upper GI series. Also called a barium swallow, 这个测试可以帮助你的十大赌博平台排行榜确定你是否有吞咽问题,这可能与胃反流的症状和体征相似. The test involves swallowing barium, a contrast material that shows up on X-rays, 技师会给你的胸部和颈部拍x光片.
- Endoscopy. 这个手术可以让我们通过内窥镜看到你的食道, a camera mounted on a small, flexible tube. 内窥镜检查由胃肠病学家执行,是门诊手术. 该检查可以显示长期酸暴露是否对食道内壁造成损伤.
如果你吞咽疼痛,十大赌博平台排行榜可能会建议你做内窥镜检查, 不明原因的体重减轻或出血(深色大便或吐血).
Treatment
胃食管反流的治疗取决于疾病的严重程度. 所有患者都应改变饮食和生活方式,以减少反流的症状和并发症.
对于患者来说,重要的是要意识到我们不知道治疗反流胃食管反流是否会影响潜在肺部疾病的病程. However, patients should discuss treatment with their doctors, 以避免不受控制的胃反流的长期并发症.
Lifestyle changes
Lifestyle modifications include:
- Weight loss
- Smoking cessation
- 把床头抬高6到8英寸——你可以在床腿下面垫几块木头, or a foam wedge under your mattress
- Avoiding foods that cause acid reflux: caffeine, chocolate, alcohol, peppermint, and fatty or spicy foods
- 避免吃得太多或太晚——吃完后不要马上躺下, and eat three or more hours before bedtime
Medications
Medications for Mild GERD include:
- Antacids. These provide short-term relief. Examples include Tums, Maalox and Mylanta.
- Histamine antagonists. These reduce acid production in the stomach, but are less effective than proton pump inhibitors, described below. 例如雷尼替丁(Zantac)、法莫替丁(Pepcid)和西咪替丁(Tagamet)。.
Medications for moderate to severe GERD:
- Proton pump inhibitors (PPI). PPIs reduce acid production in the stomach. Examples include omeprazole (Prilosec), esopmeprazole (Nexium), lansoprazole (Prevacid), dexlansoprazole (Kapidex), pantoprazole (Protonix) and rabeprazole (Aciphex).
这些药物通常是安全且耐受性良好的, 但如果长时间服用,它们可能会增加患肺炎的风险, gut infections or bone fractures.
If these treatments don't control your symptoms, 你的十大赌博平台排行榜可能会考虑使用不同的PPI或增加PPI的剂量. 在最严重的情况下,你的十大赌博平台排行榜可能会建议手术治疗你的反流.
加州大学旧金山分校健康医学专家已经审查了这些信息. 它仅用于教育目的,并不打算取代您的十大赌博平台排行榜或其他医疗保健提供者的建议. 我们鼓励您与您的供应商讨论您可能遇到的任何问题或疑虑.