Refrakterní refluxní choroba jícnu

9. 9. 2014 8:22
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Autor: Redakce

Souhrn Jako refrakterní refluxní choroba jícnu je klasifikován stav, kdy i přes maximální léčbu refluxní symptomy přetrvávají nebo se mohou objevit nové a selhává hojení ezofagitidy. Za maximální léčbu je považováno podávání inhibitoru protonové pumpy v plné dávce 2krát denně. Nelze vyloučit, že část pacientů s refrakterní refluxní chorobou jícnu není dostatečně vyšetřena. Diferenciální diagnostika refrakterních příznaků je obtížnější při ezofagitidě non-erozívní než při ezofagitidě erozívní. Klíčová slova refrakterní refluxní choroba jícnu • erozívní ezofagitida • non-erozívní ezofagitida • inhibitor protonové pumpy • prokinetikum Summary Lukas, K. Refractory gastroesophageal reflux disease Gastroesophageal reflux disease is defined as presence of acid-reflux-related symptoms, or esophageal mucosal damage, caused by abnormal reflux of gastric contents into the esophagus. Diagnosis of gastroesophageal reflux disease is relatively easy when patients complain of typical acid-reflux-related symptoms and/or esophageal mucosal breaks are seen by esophagogastroduodenal endoscopy. Refractory gastroesophageal reflux disease is defined as despite twice daily od proton pump inhibitors, reflux symptoms may persist, new symtoms may occur or be unmasked, and esophagitis may fail to heal. Key words refractory gastroesophageal reflux disease • erosive esophagitis • non-erosive esophagitis • proton pump inhibitor



  1. metrii, 6. zvážit možná další onemocnění, která se projeví postižením jícnu (ezofagitidu polékovou, infekční, při onemocnění kůže atd).

Na závěr je nutno vyslovit upozornění, že refrakterní refluxní symptomy, zejména při normálním endoskopickém nálezu, jsou závažným diagnostickým problémem a vyžadují řádné vyšetření!

S podporou MZČR-RVO VFN 64165.
Prohlášení: autor v souvislosti s tématem práce v posledních 12 měsících nespolupracoval s žádnou farmaceutickou firmou..

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e-mail: klukas@vfn.cz

O autorovi| MUDr. Karel Lukáš, CSc. Univerzita Karlova v Praze, 1. lékařská fakulta a Všeobecná fakultní nemocnice, IV. interní klinika – klinika gastroenterologie a hepatologie

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