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Prävalenz und natürlicher Verlauf der gastroösophagealen Refluxkrankheit

Prevalence and natural course of gastroesophageal reflux disease

  • Schwerpunkt: Reflux und Dysphagie
  • Published:
Der Gastroenterologe Aims and scope

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Zusammenfassung

Hintergrund

Die Epidemiologie einer Krankheit, insbesondere der natürliche Verlauf, ist für die Planung von Therapie- und Überwachungsstrategien von entscheidender Bedeutung.

Fragestellung

Inzidenz, Prävalenz und natürlicher Verlauf der gastroösophagealen Refluxkrankheit (GERD).

Material und Methode

Selektive Literaturrecherche in der Datenbank PubMed.

Ergebnisse

In Ländern der westlichen Welt leidet jeder 5. Erwachsene an einer symptomatischen GERD. Asymptomatische Refluxösophagitiden und Barrett-Ösophagi wurden darüber hinaus bei mehr als 5 % der Bevölkerung in einer Populationsstudie mit Endoskopie beobachtet. Spontanheilungen der GERD kommen vor, die Mehrzahl der Erkrankungen verläuft allerdings chronisch. Die GERD ist keine kategorielle Erkrankung. Etwa 25–30 % der Patienten weisen im Verlauf eine Progression der endoskopischen Läsionen auf. Das Karzinomrisiko des Barrett-Ösophagus ist mit 0,1–0,15 % pro Jahr geringer als lange Zeit angenommen. Insgesamt geht die GERD nicht mit einer verkürzten Lebenserwartung einher. Die Epidemiologie von extraösophagealen Symptomen ist weitgehend unbekannt.

Schlussfolgerungen

Die GERD ist eine häufige Erkrankung mit guter Prognose quoad vitam. Spontanheilungen kommen ebenso vor wie Progressionen der endoskopischen Läsionen. Das Karzinomrisiko des Barrett-Ösophagus ist geringer als angenommen, aus diesem Grund sollten sich Überwachungen auf Risikopatienten beschränken.

Abstract

Background

The epidemiology of a disease, in particular the natural course, is important for treatment planning and monitoring strategies.

Objective

Incidence, prevalence, and natural course of gastroesophageal reflux disease (GERD).

Materials and methods

Selective literature search in the database PubMed.

Results

In industrialized countries, approximately 20 % of adults suffer from symptomatic GERD. In addition, asymptomatic esophageal reflux and Barrett esophagus was observed in more than 5 % of the general public in an endoscopic population based study. Spontaneous healing of GERD does occur, but in the majority of cases the disease is chronic. GERD is not a categorical disease. Approximately 25–30 % of patients have endoscopic progression of their disease over time. The cancer risk of Barrett esophagus is estimated to be 0.1–0.15 % per year, which is less than originally assumed. Overall, GERD is not associated with a shortened life expectancy. The epidemiology of extra-esophageal symptoms is largely unknown.

Conclusion

GERD is a common disease with a good prognosis with regard to survival. Spontaneous recovery occurs as well as progression of endoscopic lesions. The cancer risk of Barrett esophagus is lower than expected; thus, surveillance should be limited to high-risk patients.

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Correspondence to J. Labenz.

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J. Labenz und C. Labenz geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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M. Fried, Zürich

J.F. Riemann, Ludwigshafen

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Labenz, J., Labenz, C. Prävalenz und natürlicher Verlauf der gastroösophagealen Refluxkrankheit. Gastroenterologe 11, 102–109 (2016). https://doi.org/10.1007/s11377-016-0045-0

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