Zusammenfassung
Die gastroösophageale Refluxkrankheit ist in den westlichen Industrieländern eine der, wenn nicht die häufigste gutartige Funktionsstörung im Gastrointestinaltrakt überhaupt. Ihr soll deshalb in dieser Sektion entsprechender Platz eingeräumt werden. Die Prävalenz beträgt 360 pro 100000 Personen und die Inzidenz 86 pro 100 000 Personen pro Jahr [58]. Der zugrundeliegende pathophysiologische Mechanismus besteht in einem exzessiven Rückfluß von Magensaft in die Speiseröhre, gefolgt von Schleimhautschäden und/ oder klinisch auftretenden Beschwerden [12]. Die Vielfalt der auftretenden Beschwerden, die multifaktoriellen Ursachenkomponenten, die zu diesem abnormalen Rückfluß beitragen und die schlecht beurteilbare und individuell unterschiedliche Fähigkeit der Schleimhautabwehr in der Speiseröhre führen zu klinischen und diagnostischen Unsicherheiten, die auch eine präzise Definition der Erkrankung erschweren. In der Vergangenheit wurde die Refluxkrankheit eine gewisse Zeit radiologisch definiert, bei Vorliegen einer Hiatus-hernie am gastroösophagealen Übergang und der Möglichkeit einer Provokation eines Kontrastmittelrückflusses während der Röntgenuntersuchung [1, 49]. Der Zusammenhang zwischen Hiatushernie und Refluxkrankheit wird weiterhin kontrovers diskutiert [12]. Die Inzidenz besonders einer axialen Hiatushernie, meistens einer Gleithernie, nimmt im Alter zu. Die meisten Patienten mit einer Hiatushernie haben keinen pathologischen Reflux, daher hat die axiale Hiatushernie keine zwingende pathologische Bedeutung im Sinne einer Krankheit.
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Fuchs, KH. (1997). Pathophysiologie. In: Fuchs, KH., Stein, H.J., Thiede, A. (eds) Gastrointestinale Funktionsstörungen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60372-3_36
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