91. Pathophysiologie, Klinik und rationelle Diagnostik der gastrooesophagealen Refluxkrankheit und der axialen Hiatushernie

Abstract

Low pressure or inappropriate relaxation of the lower esophageal sphincter, disturbances in esophageal peristalsis and delayed gastric emptying are the most important pathogenetic factors of reflux disease. In general, retrosternal and also epigastric and pharyngeal burning or pain are the leading symptoms, but in mild disease eructation may become the major complaint. Diagnosis is usually made on the basis of a typical history and the results of endoscopy. 24-h-pH-recording is indicated in inconclusive endoscopy, chest pain of unknown origin and preoperative evaluation. Manometry may be indicated to exclude systemic sclerosis.

Epidemiology of Reflux Disease and Reflux Esophagitis

“…Symptoms do not pennit a differentiation between gastroesophageal reflux without inflammation and reflux esophagitis. In general, heartburn iz the leading symptom in esophagitis, and eructation may he the major complaint in niild rsophagitis (1). But in specific patient proupb epigastric pain may become the leading symptoni (2).…”