Hopp til hovedinnhold

Gastroøsofageal reflukssykdom (GØRS)

Sist oppdatert: Sist revidert:
Sist revidert av:
Definisjon:
En sykdom som skyldes refluks av ventrikkel/duodenalinnhold til øsofagus og eventuelt luftveier
Forekomst:
Forekommer hos 5-10% av den voksne befolkningen. Bare halvparten av de som endoskoperes, har øsofagitt
Symptomer:
Brystbrann (halsbrann), sure oppstøt, sviende ubehag og ev. smerte fra epigastriet opp bak sternum
Funn:
Sjelden kliniske funn av betydning for diagnosen
Diagnostikk:
Endoskopi, ev. supplert med 24h pH-måling
Behandling:
Livsstilsendringer, syrehemmende midler, ev. kirurgi
  1. Baird DC, Harker DJ, Karmes AS. Diagnosis and treatment of gastroesophageal reflux in infants and children. Am Fam Physician. 2015 Oct 15;92(8):705-717.
  2. Katzka DA, Kahrilas PJ. Advances in the diagnosis and management of gastroesophageal reflux disease. BMJ. 2020 Nov 23;371:m3786. PMID: 33229333. PubMed  
  3. Maret-Ouda J, Markar SR, Lagergren J. Gastroesophageal Reflux Disease. JAMA. 2020;324(24):2565. PubMed  
  4. Nguyen AD, Spechler SJ, Shuler MN, Souza RF, Dunbar KB. Unique Clinical Features of Los Angeles Grade D Esophagitis Suggest That Factors Other Than Gastroesophageal Reflux Contribute to its Pathogenesis. J Clin Gastroenterol. 2019;53(1):9-14. PubMed  
  5. Eusebi LH, Ratnakumaran R, Yuan Y, Solaymani-Dodaran M, Bazzoli F, Ford AC. Global prevalence of, and risk factors for, gastro-oesophageal reflux symptoms: a meta-analysis. Gut. 2018;67(3):430-440.
  6. Chang AB, Lasserson TJ, Gaffney J, et al. Gastro-oesophageal reflux treatment for prolonged non-specific cough in children and adults. Cochrane Database Syst Rev, issue 1, 2011;CD004823. Cochrane (DOI)  
  7. Kahrilas PJ, Howden CW, Hughes N, et al. Response of chronic cough to acid-suppressive therapy in patients with gastroesophageal reflux disease. Chest 2013 Mar;143(3):605-12 . pmid:23117307. PubMed  
  8. Kahrilas PJ. Clinical manifestations and diagnosis of gastroesophageal reflux in adults. UpToDate, last updated Jul 15, 2022. www.uptodate.com  
  9. Bujanda DE, Hachem C. Barrett's Esophagus. Mo Med. 2018 May-Jun;115(3):211-213. PMID: 30228724. PubMed  
  10. Pandolfino JE. Helicobacter pylori and gastroesophageal reflux disease. UpToDate, last updated Jun 05, 2023. UpToDate  
  11. Bytzer P, Jones R, Vakil N, Junghard O, Lind T, Wernersson B, Dent J. Limited ability of the proton-pump inhibitor test to identify patients with gastroesophageal reflux disease. Clin Gastroenterol Hepatol 2012;10: 1360-6. PubMed  
  12. American Lung Association Asthma Clinical Research Centers, Mastronarde JG, Anthonisen NR, et al. Efficacy of esomeprazole for treatment of poorly controlled asthma. N Engl J Med. 2009;360:1487-1499. PubMed  
  13. Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013;108(3):308-328.
  14. Gyawali CP, Kahrilas PJ, Savarino E, et al. Modern diagnosis of GERD: the Lyon Consensus. Gut. 2018;67(7):1351-1362.
  15. Farrell B, Pottie K, Thompson W et al. Deprescribing proton pump inhibitors: Evidence-based clinical practice guideline. Can Fam Physician. 2017 May;63(5):354-364. PMID: 28500192 PubMed  
  16. Katz PO, et al. Guidelines for the diagnosis and management of gastroesophageal reflux disease published correction appears in Am J Gastroenterol. 2013;108(10): 1672. Am J Gastroenterol. 2013;108(3):308–328.
  17. Zuckerman MJ, Carrion AF. Gastro-oesophageal reflux disease. BMJ Best Practice, last updated 26 Nov, 2019. bestpractice.bmj.com  
  18. Kahrilas PJ. Medical management of gastroesophageal reflux disease in adults. UpToDate, last updated Sep 19, 2022. UpToDate  
  19. Epstein D, Bojke L, Sculpher MJ. The reflux trial group. Laparoscopic fundoplication compared with medical management for gastro-oesophageal reflux disease: a cost effectiveness study. BMJ 2009; 338: b2576. BMJ (DOI)  
  20. Grant AM, Boachie C, Cotton SC, et al. Clinical and economic evaluation of laparoscopic surgery compared with medical management for gastro-oesophageal reflux disease: 5-year follow-up of multicentre randomised trial (the REFLUX trial). Health Technol Assess 2013 Jun;17(22):1-167. doi: 10.3310/hta17220. DOI  
  21. Galømiche J-P, Hatlebakk J, Attwood S, et al. Laparoscopic antireflux surgery vs esomeprazol treatment for chronic GERD. JAMA 2011; 305: 1969-77. Journal of the American Medical Association  
  22. Xie Y, Bowe B, Yan Y, et al. Estimates of all cause mortality and cause specific mortality associated with proton pump inhibitors among US veterans: cohort study. BMJ 2019; 365: l1580. PMID: 31147311 PubMed  
  23. Phupong V, Hanprasertpong T. Interventions for heartburn in pregnancy. Cochrane Database of Systematic Reviews 2015, Issue 9. Art. No.: CD011379.pub2 Cochrane (DOI)  
  24. Matok I, Gorodischer R, Koren G et al. The safety of H(2)-blockers use during pregnancy. J Clin Pharmacol 2010; 50(1): 81-7. pmid:19789371 PubMed  
  25. Gill SK, O'Brien L, Einarson TR, Koren G. The safety of proton pump inhibitors (PPIs) in pregnancy: a meta-analysis. Am J Gastroenterol 2009; 104(6): 1541. pmid:19491869 PubMed  
  26. Hatlebakk JG, Emken BE, Glazkov V, Hoff DA, Hausken T. Correct use of proton pump inhibitors for gastro-oesophageal reflux disease. Tidsskr Nor Laegeforen 2013; 133: 43-46. pmid:23306993 PubMed  
  27. 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. PubMed  
  28. Sigterman KE, van Pinxteren B, Bonis PA, Lau J, Numans ME. Short-term treatment with proton pump inhibitors, H2-receptor antagonists and prokinetics for gastro-oesophageal reflux disease-like symptoms and endoscopy negative reflux disease. Cochrane Database of Systematic Reviews 2013, Issue 5. Art. No.: CD002095. DOI: 10.1002/14651858.CD002095.pub5. DOI  
  29. Teng M, Khoo AL, Zhao YJ et al. Meta-analysis of the effectiveness of esomeprazole in gastroesophageal reflux disease and Helicobacter pylori infection. J Clin Pharm Ther. 2015;40(4):368-75 PubMed  
  30. Kang SJ, Jung HK, Tae CH, Kim SY, Lee KJ. On-demand Versus Continuous Maintenance Treatment of Gastroesophageal Reflux Disease With Proton Pump Inhibitors: A Systematic Review and Meta-analysis. J Neurogastroenterol Motil. 2022;28(1):5-14. PubMed  
  31. Song H, Zhu J, Lu D. Long-term proton pump inhibitor (PPI) use and the development of gastric pre-malignant lesions. Cochrane Database of Syst Rev 2014; 12: CD010623. doi:10.1002/14651858.CD010623.pub2 DOI  
  32. 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. PubMed  
  33. Kiljander TO, Junghard O, Beckman O, Lind T. Effect of esomeprazole 40 mg once or twice daily on asthma: a randomized, placebo-controlled study. Am J Respir Crit Care Med 2010; 181: 1042-8. PubMed  
  34. Garg SK, Gurusamy KS. Laparoscopic fundoplication surgery versus medical management for gastro-oesophageal reflux disease (GORD) in adults. Cochrane Database Syst Rev. 2015;(11):CD003243. Cochrane (DOI)  
  35. Grant AM, Cotton SC, Boachie C, et al. Minimal access surgery compared with medical management for gastro-oesophageal reflux disease: five year follow-up of a randomised controlled trial (REFLUX). BMJ 2013; 346: f1908. doi:10.1136/bmj.f1908 DOI  
  36. American Lung Association Asthma Clinical Research Centers, Mastronarde JG, Anthonisen NR, et al. Efficacy of esomeprazole for treatment of poorly controlled asthma. N Engl J Med. 2009 Apr 9;360(15):1487-99. PubMed  
  37. Shaheen NJ, Falk GW, Iyer PG, Gerson LB; American College of Gastroenterology. ACG Clinical Guideline: Diagnosis and Management of Barrett's Esophagus. Am J Gastroenterol. 2016 Jan;111(1):30-50; quiz 51. Epub 2015 Nov 3. Erratum in: Am J Gastroenterol. 2016 Jul;111(7):1077. PMID: 26526079. PubMed  
  38. Maret-Ouda J, Wahlin K, Artama M, et al. Risk of Esophageal Adenocarcinoma After Antireflux Surgery in Patients With Gastroesophageal Reflux Disease in the Nordic Countries. JAMA Oncology 2018. doi:10.1001/jamaoncol.2018.3054 DOI  
  39. Panzuto F, Di GE, Capurso G et al. Large hiatal hernia in patients with iron deficiency anaemia: a prospective study on prevalence and treatment. Aliment Pharmacol Ther 2004; 19: 663-70. PubMed  
  40. Corazziari ES, Gasbarrini A, D`Alba L, et al. Poliprotect vs Omeprazole in the Relief of Heartburn, Epigastric Pain, and Burning in Patients Without Erosive Esophagitis and Gastroduodenal Lesions: A Randomized, Controlled Trial. Am J Gastroenterol. 2023. PMID: 37307528 PubMed  
  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Jan Hatlebakk, overlege, professor dr. med., Gastroenterologisk seksjon, Medisinsk avdeling, Haukeland Universitetssykehus, Bergen
  • Klaus Theede, overlæge, ph.d., Gastroenheden, medicinsk sektion, Amager og Hvidovre hospital (Lægehåndbogen)