大部分患者对质子泵抑制剂治疗有效。推荐对停用质子泵抑制剂后症状复发的患者以及糜烂性食管炎和 Barrett 食管患者使用质子泵抑制剂维持治疗。[1]Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013 Mar;108(3):308-28.http://gi.org/guideline/diagnosis-and-managemen-of-gastroesophageal-reflux-disease/http://www.ncbi.nlm.nih.gov/pubmed/23419381?tool=bestpractice.com 大部分患者停用质子泵抑制剂治疗后复发。然而,长期使用这些药物具有风险;因此,应以尝试停药或将剂量减至控制症状所需的最低剂量为目标进行治疗。[43]Freedberg DE, Kim LS, Yang YX. The risks and benefits of long-term use of proton pump inhibitors: expert review and best practice advice from the American Gastroenterological Association. Gastroenterology. 2017 Mar;152(4):706-15.http://www.ncbi.nlm.nih.gov/pubmed/28257716?tool=bestpractice.com
食管腺癌可能是胃食管反流病较少见而又严重的并发症。当初始内镜检查在愈合黏膜中未见狭窄、Barrett 化生或腺癌的时候,随访 7 年时间内发展成腺癌的风险约为 0.1%。[3]Kahrilas PJ, Shaheen NJ, Vaezi MF, et al. American Gastroenterological Association medical position statement on the management of gastroesophageal reflux disease. Gastroenterology. 2008;135:1383-91.http://www.gastrojournal.org/article/S0016-5085%2808%2901606-5/fulltexthttp://www.ncbi.nlm.nih.gov/pubmed/18789939?tool=bestpractice.com