胃食管反流（GORD）

Key points about GORD

1. GORD诊断时胃灼热每周持续2次或更多次。
2. Acid reflux from your stomach can cause damage to the lining of your oesophagus.
3. GORD is more common in smokers, pregnant women, heavy drinkers, people who are overweight and people aged between 35 and 64 years.
4. 未经处理的戈德可能导致严重的并发症。
5. A combination of medicine and lifestyle changes are used to treat GORD.

（克利夫兰诊所，美国，2019年）

What causes GORD?

After you swallow food, it travels down your oesophagus (the tube between your throat and stomach) into your stomach. A ring of muscle (called the lower oesophageal sphincter) acts as a valve between your oesophagus and your stomach. This valve prevents stomach acid from going back up your oesophagus.

当瓣膜无法正常工作时，戈德就会发生，并且使酸（反流）进入食道。这被称为酸回流。如果您经常有胃酸反流，则可能导致食道衬里的炎症。这被称为食管炎。

图片来源：帆布

戈德的症状是什么？

Heartburnis the main symptom of GORD. This is a burning feeling that rises up from your upper stomach or lower chest up towards your neck.

其他常见症状包括：

• pain in your upper abdomen or chest
• feeling sick (nausea)
• an acid taste in your mouth
• 消化不良(dyspepsia)
• 吞咽热饮料时会灼痛。

These symptoms tend to be worse after a meal.

不太常见的酸刺激引起的症状nearby windpipe include:

• 持续的咳嗽，尤其是晚上
• 喘息
• 口腔或喉咙症状，例如口香糖问题，口臭，喉咙痛或嘶哑
• severe chest pain which may be mistaken for a heart attack.

戈德有什么风险因素？

戈德的主要危险因素之一是超重。随着您的体重指数（BMI）的增加，您患Gord的风险也会增加。人们认为这是由于额外的压力施加在下部食道括约肌上the weight resting onyour stomach. Other risk factors include pregnancy, smoking, abnormalities of your oesophagus and eating certain foods.

Pregnancy

Many women get heartburn during later stages of pregnancy, when your womb pushes up against your stomach. This normally goes away at the end of the pregnancy.

抽烟

Nicotine can cause the muscles of the lower oesophageal sphincter to relax which may allow reflux to occur. GORD in smokers is also thought to be caused by frequent coughing leading to hiatus hernia. A hiatus hernia is where the upper part of your stomach is pushed up into your upper chest cavity through an opening in your diaphragm, affecting the functioning of the lower oesophageal sphincter. Read more about中断疝。

Abnormalities of the oesophagus

这些可能导致胃含量（包括酸和有时是胆汁）流入食道。

吃某些食物

Foods that can make the symptoms of GORD worse include:

• spicy foods
• acidic fruits and vegetables, like citrus or tomatoes
• mint or chocolate
• 咖啡因
• alcohol
• garlic and onions
• fried or fatty food.

戈德如何被诊断？

See your doctor if you are having heartburn regularly and ongoing. To make a diagnosis of GORD, your doctor will take your medical history and conduct a physical examination. A diagnosis of GORD is highly likely if regular and ongoing heartburn is your main symptom. Further tests may be required to work out how severe your GORD is or whether there is any damage to your oesophagus.

Tests may include:

• an内窥镜检查– this involves having an endoscope (a flexible tube with a tiny video camera and light at one end) passed through your mouth down into your stomach to examine the lining of your digestive tract.
• pH监测 - 这涉及使用酸监测器（一端具有传感器的薄管）来测量食道中的酸度水平。

How is GORD treated?

It is important to begin treating GORD as soon as possible after diagnosis. Left untreated, acid reflux will continue to damage your oesophagus and create other complications. There are 3 main types of medicines used to treat GORD. The type of medicine prescribed depends on how severe your symptoms are. These medicines from mildest to strongest are antacids (with or without alginates), H2-receptor blockers and proton pump inhibitors.

• Antacidsneutralise stomach acids and provide rapid relief of symptoms especially if your condition is mild. Some antacid medicines also contain alginates, which are substances that form a raft on top of stomach contents. This stops food and acid from refluxing. Antacids don't help to heal oesophageal damage or prevent heartburn from happening again. Antacid brands include Mylanta, Eno, Quick-Eze and Gaviscon.Antacidsmay be prescribed or bought over the counter with advice from your pharmacist.
• H2-receptor blockersreduce the production of stomach acid and give relief in many people, especially if you have less severe GORD. They are slower acting than antacids but provide longer term relief. For many people, this treatment allows your oesophagus to heal and relieves the symptoms entirely. Examples of可用的H2受体阻滞剂包括Cimetidine And famotidine.Previouslyranitidinewas used but has been withdrawn from sale due to safety concerns.
• Proton-pump inhibitors (PPIs)阻止胃酸的产生，并有助于治愈食道。建议他们用于严重的戈德症状。他们iNclude奥美拉唑和lansoprazole。阅读更多有关proton-pump inhibitors。

After your oesophagus has had a chance to heal and your symptoms improve, the strength of medicine prescribed will be reduced. Eventually you may only need to take medicine when you have symptoms. For some people with severe GORD, the lowest effective dose of medicine may need to be continued.

药物可有效治疗Gord，但它们只是解决方案的一部分。为了防止戈德的症状反复出现，您可能需要改变一些重要的生活方式。

What self-care can I do with GORD?

There are a number of lifestyle changes you can make that might help reduce heartburn and acid reflux:

• If you are overweight, try losing weight. Excess weight puts pressure on your stomach, causing acid to back up your oesophagus.
• 看着你吃的东西和吃多少。避免食物引发您的胃灼热，并尽量不要填补胃。
• 如果您抽烟，请退出。吸烟会影响食道括约肌/瓣膜的功能。
• 减少您喝多少酒精和咖啡因。
• 饭后保持直立，并使用重力来减轻胃酸。吃饭后至少等待3个小时，然后躺下或上床睡觉。
• 如果经常或晚上发生症状，请将床头抬高10厘米（以抬起头部比胃部略高）​​。
• Avoid or reduce the use ofnon-steroidal anti-inflammatory drugs (NSAIDs)。

学到更多

Heartburn (reflux)澳大利亚胃肠病学学会
胃酸反流和食管炎英国Depertainfo

审查

	Dr Alice Miller自2013年以来一直在新西兰工作，并一直在新西兰工作。爱丽丝（Alice）对预防健康和自我保健有特别的兴趣，她通过在惠灵顿奥塔哥大学（University of Otago）学习公共卫生文凭来建立这一目标。