| Abstract | Gastroezofagealna refluksna bolest (GERB) predstavlja skup simptoma i posljedica koje na jednjaku izaziva gastroezofagealni refluks. Gastroezofagealni refluks (GER) jest vraćanje želučanog sadržaja u jednjak i usnu šupljinu pri čemu se pojavljuju žgaravica, regurgitacija, bol u prsima i disfagija. GERB predstavlja značajan javnozdravstveni problem zapadne civilizacije jer se simptomi te bolesti pojavljuju u 20 % – 40 % populacije, a 7 % – 15 % odraslih osoba pati od žgaravice. GERB nastaje zbog poremećene funkcije donjega ezofagealnog sfinktera (DES). Klinički se može manifestirati tipičnim refluksnim simptomima (žgaravica, regurgitacija želučanog sadržaja), alarmantnim refluksnim simptomima (disfagija, krvarenje, anemija, gubitak tjelesne mase) te atipičnim refluksnim ili ekstraezofagealnim simptomima (simptomi koji nastaju zbog uha, grla i nosa: promuklost, kronični kašalj, upala srednjeg uha (otitis), kronični laringitis; simptomi vezani uz prsni koš: apneja pri spavanju, odinofagija (otežano gutanje), štucanje, bol u prsima; simptomi koji nastaju zbog dišnog sustava: kronični kašalj, astma, upala pluća, plućna fibroza; simptomi koji nastaju zbog kardijalnog sustava: bol iza prsne kosti koja imitira anginoznu bol; simptomi koji nastaju zbog želudca: mučnina, nadutost, brzo zasićivanje, epigastrička bol te oralne manifestacije). Oralne manifestacije obuhvaćaju dentalne erozije, preosjetljivost zuba, stomatopirozu i poremećaj okusa (disgeuziju), hipersalivaciju, suhoću usta (kserostomiju), halitozu eritem i erozije sluznice te sniženje vertikalne dimenzije okluzije. U dijagnostičkom postupku važna je anamneza koja otkriva dužinu trajanja, intenzitet, kontinuitet i provokativne čimbenike simptoma. Odsutnost žgaravice, odinofagije ili regurgitacije, uz postojanje atipičnih simptoma (plućni simptomi, erozije zubne cakline, kronični laringitis, štucanje), trebala bi pobuditi sumnju na GERB u čijoj dijagnostici zlatni standard predstavlja ezofagogastroduodenoskopija (endoskopski pregled jednjaka, želudca i dvanaesnika). Dijagnoza GERB-a postavlja se u određenim slučajevima i pH-metrijom. |
| Abstract (english) | Gastroesophageal reflux disease (GERD) represents a set of symptoms and ramifications caused by esophageal gastroesophageal reflux. Gastroesophageal reflux (GERD) indicates the return of gastric contents to the esophagus and oral cavity and the onset of symptoms such as heartburn, regurgitation, chest pain and dysphagia. GERD is a significant public health problem in Western civilization because the symptoms of the disease that occurs in 20-40% of the population and 7-15% of adults suffer from heartburn. GERD is caused by impaired function of the lower esophageal sphincter (LES).
GERD can be clinically manifested by typical reflux symptoms (heartburn, regurgitation of gastric contents), alarming reflux symptoms (dysphagia, bleeding, anemia, weight loss), and atypical reflux or extra-oesophageal symptoms (symptoms of ear, throat, and nose) , middle ear inflammation (otitis), chronic laryngitis; chest related symptoms: sleep apnea, odinophagia (difficulty swallowing), hiccups, chest pain; respiratory symptoms: chronic cough, asthma, pneumonia, pulmonary fibrosis; symptoms of the cardiac system: pain behind the chest that mimics anginal pain; symptoms of the stomach: nausea, flatulence, rapid satiation, epigastric pain and oral manifestations). Oral manifestations include dental erosion, tooth hypersensitivity, stomatopyrosis and taste disorders (dysgeusia), hypersalivation, dry mouth (xerostomia), erythema halitosis and erosion of the mucosa and reduction of the vertical dimension of the occlusion. An anamnesis is important in the diagnostic procedure, revealing to us the duration, intensity, continuity and provocative factors of the symptoms. Absence of heartburn, odinophagy or regurgitation with atypical symptoms (pulmonary symptoms, tooth erosion, chronic laryngitis, hiccups) should raise suspicion of GERD in the diagnosis of which the gold standard is esophagogastroduodenoscopy (endoscopic examination of the esophagus, gastric ulcer). The diagnosis of GERD is also made in some cases by pH-metry. |
