| Management of refractory GERD |
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Yong Chan Lee |
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1동아대학교 의과대학 내과학교실, 2부산의료원 신장내과 |
| 불응성 위식도역류질환에 대한 치료 |
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이용찬 |
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1Department of Internal Medicine, Dong-A University College of Medicine; 2Division of Nephrology, Busan Medical Center, Busan, Korea |
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| Abstract |
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Approximately 25% of patients with typical gastroesophageal disease (GERD) symptoms do not respond to double dose of proton pump inhibitors (PPI), and might have refractory GERD. The causes of refractory GERD include poor compliance, esophageal motility disorder, duodeno-gastroesophageal reflux, eosinophilic esophagitis, nonacid reflux, functional heartburn, and inadequate acid suppression. when patient compliacne have been confirmed, it is reasonable to escalate to twice dose of PPI. Upper gastrointestinal endoscopy should be performed to rule out other disorders such as esophageal esophagitis, pill induced esophagitis, or esophageal involvement of autoimmune disorders. If symptoms persist despite double dose PPI, 24 hr pH-impedance monitoring, esophageal manometry, and scintigraphic gastric emptying scan may be required. (Korean J Med 78:301-308, 2010) |
| Key Words:
Refractory GERD |
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