hrvatski

Gastroezofagealna refluksna bolest i Helicobacter pylori infekcija

SAŽETAK: Gastroezofagealna refluksna bolest (GERB) jedna je od najčešćih bolesti gornjeg dijela gastrointestinalnog sustava. Prisutna je u svim svjetskim populacijama, a osobito je česta u razvijenim zemljama. Nastaje zbog patološkog refluksa želučanog sadržaja u jednjak. Ovo pretjerano izlaganje jednjaka želučanom sadržaju dovodi postepeno do nadvladavanja obrambenog sustava sluznice jednjaka. Patogeneza GERB-a uključuje mnoge čimbenike. Smatra se da je najvažniji poremećaj funkcije donjeg ezofagealnog sfinktera, odnosno njegova pretjerana relaksacija. Težina bolesti proporcionalna je količini refluksnog sadržaja iz želuca i dužini trajanja izloženosti jednjaka tom sadržaju. Postoji više razloga zbog kojih je GERB danas u središtu zanimanja. Jedan od njih je uloga GERB-a pri razvoju specifičnog oboljenja donjeg dijela jednjaka – Barrettovog jednjaka, kao i u nastanku adenokarcinoma jednjaka, malignog tumora čija je prevalencija u porastu. Naime, danas se smatra da je neprepoznat i nedovoljno liječen GERB jedan od najvažnijih razloga nastanka adenokarcinoma jednjaka. Odnos između GERB-a i Helicobacter pylori infekcije zadnjih je godina predmet opsežnih istraživanja mnogih eminentnih stručnjaka diljem svijeta. SUMMARY: Gastroesophageal reflux disease (GERD) is one of the common diseases of the upper gastrointestinal system. It is present in the whole world population, especially frequent in the developed countries. It evolves from pathological reflux which exposes the esophagus to the gastric contents which must overcome esophageal defense system. Many factors have been found to be involved in the pathogenesis of GERD ; the most important one is the relaxation of the lower esophageal sphincter. Intensity of the disease is proportional to the amount of gastric contents refluxing from the stomach and the duration of esophageal exposure to this contents. GERD is currently in the spotlight because of its special significance in the development of very specific disease in the lower part of the esophagus – Barrett's esophagus, as well as esophageal adenocarcinoma which has lately been increasing in prevalence. Today, unrecognized and inadequately cured GERD is known to be a high risk factor for adenocarcinoma of the esophagus. In recent years the relation between GERD and Helicobacter pylori infection has been the topic of investigation by many prominent researchers. Therapy of GERD is based on inhibition of acid secretion. There are many different therapeutic agents available however proton pump inhibitors (PPI) are considered to be the most effective in the treatment of this disease.

Gastroezofagealna refluksna bolest; GERB; Barrettov jednjak; adenokarcinom jednjaka; Helicobacter pylori

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