Gastroesophageal reflux following peroral endoscopic myotomy for achalasia:Bumps in the road to success  

作　　者：David Itskoviz Stephen David Howard Malnick 

机构地区：[1]Kaplan Medical Center,Institute of Gastroenterology and Hepatology,Hebrew University Medical School of Jerusalem,Rehovot 76100,Israel [2]Kaplan Medical Center,Department of Internal Medicine C,Hebrew University Medical School of Jerusalem,Rehovot 76100,Israel

出　　处：《World Journal of Gastroenterology》2024年第29期3461-3464,共4页世界胃肠病学杂志（英文版）

摘　　要：Achalasia can significantly impair the quality of life.The clinical presentation typically includes dysphagia to both solids and liquids,chest pain,and regurgitation.Diagnosis can be delayed in patients with atypical presentations,and they might receive a wrong diagnosis,such as gastroesophageal reflux disease(GERD),owing to overlapping symptoms of both disorders.Although the cause of achalasia is poorly understood,its impact on the motility of the esophagus and gastroesophageal junction is well established.Several treatment modalities have been utilized,with the most common being surgical Heller myotomy with concomitant fundoplication and pneumatic balloon dilatation.Recently,peroral endoscopic myotomy(POEM)has gained popularity as an effective treatment for achalasia,despite a relatively high incidence of GERD occurring after treatment compared to other modalities.The magnitude of post-POEM GERD depends on its definition and is influenced by patient and procedure-related factors.The longterm sequelae of post-POEM GERD are yet to be determined,but it appears to have a benign course and is usually manageable with clinically available modalities.Identifying risk factors for post-POEM GERD and modifying the POEM procedure in selected patients may improve the overall success of this technique.

关 键 词：ACHALASIA Per-oral endoscopic myotomy Gastroesophageal reflux Pneumatic dilatation Heller myotomy Proton pump inhibitor Acidic fermentation 

分 类 号：R573.7[医药卫生—消化系统]