我国胃食管反流患者超1亿!长期不愈会增加患癌风险,你可别大意

2020-09-26 39健康网 39健康网

胃食管反流,目前我国的发病人数高达1.65亿,在这其中,又有1600多万患者,会发展成为更加严重的反流性食管炎。反流性食管炎相比胃食管反流会更加严重,而且还伴随着食管狭窄、溃疡和消化道出血等多种并发症

"老李有十多年的饮酒史,近段时间总是觉得烧心,反酸, 有时一低头,嘴里就会冒酸水,去医院做了好几次检查,呼吸内科、耳鼻喉科、胸外科、骨外科……都找不到病因,症状也一直没得到缓解,老李很受折磨。

后来与朋友无疑交谈,朋友也出现过类似情况,介绍他去某三甲医院检查,结果诊断是胃食管反流。

胃食管反流的发病情况

胃食管反流,目前我国的发病人数高达1.65亿,在这其中,又有1600多万患者,会发展成为更加严重的反流性食管炎。

反流性食管炎相比胃食管反流会更加严重,而且还伴随着食管狭窄、溃疡和消化道出血等多种并发症。所以,临床上如果患者的病情持续加重的话,平常的工作和生活将会受到很大的困扰。

胃食管反流易与其他疾病混淆

胃食管反流的主要症状是反酸和烧心,有的时候会误认为是呼吸系统和血管方面的疾病。由于反流物的刺激,患者还会出现胸痛、气喘、喉咙痛以及咳嗽等多种症状。如果症状典型的话,患者往往能够直接到消化科去找医生治疗。

但有的时候患者会出现咳嗽、胸痛、哮喘、慢性咽炎等非典型的症状,患者本身也无法判断是哪种病情。有时候在医院各个科室里转了好多圈,也不能确定最终病因,导致错过最佳治疗时机。所以胃食管反流的患者,平时既要关注反流导致的典型症状,也要关注其延伸出来的其他症状。

胃食管反流的原因

正常情况下,我们吃饭之后,食物顺着食管进入胃部,它是由上往下去的。而胃食管反流,就是胃部和十二指肠里的食物、胃液等物质往上跑,而且还能顺着食管往上跑到咽喉部位甚至口腔里。

这种明显违反了地心引力的方式让人有点不解。我们都知道,胃和食管之间有一个部位叫贲门,贲门就像一个很特殊的阀门,食物往下走它不阻拦,食物一级胃液如果往上走的话,它就会屏蔽阻拦住。这就好比马路上的单行道,只能往下,不能往上。

而胃食管反流患者,就是这道阀门出现差错了。一旦失去了原有的正常功能,食物虽然可以继续往下走,但是胃里的胃酸也能够往上跑了。胃酸本来就是有腐蚀性的,只能呆在胃部,如果跑到食管甚至咽喉部位,人自然就感到反酸和烧心了。

长期不治会诱发癌症吗?

胃食管反流如果长期不治疗的话,诱发癌变的风险则会非常大。由于最初病变的部位就在贲门,所以发生癌变最大可能的地方也是贲门。

贲门癌在我国的发病率在逐渐上升,而在美国,贲门癌的发病率则提高了7倍之多。贲门癌并非单纯的胃癌,它处于食管和胃的中间,所以严格来说贲门癌是食管下段的腺癌。贲门癌的治疗不但需要全部切除胃部,手术创伤大,所以预后效果很差。

除了贲门癌之外,胃食管反流还会诱发食管癌。食管癌最常见的风险就是巴雷特食管现象。所谓巴雷特食管,指的是食管接触了太多的胃酸,导致食管黏膜细胞发生了变化。而胃食管反流如果长期不治疗,胃酸液体对食管的刺激也将是长期的。巴雷特食管跟胃部的肠化生现象类似,都是黏膜细胞的异性增生,接下来的阶段就是肿瘤和癌变的开始。

如何治疗胃食管反流?

目前针对胃食管反流的治疗,没有根治性的疗法,主要治疗的药物有两类。

一种是抑制胃酸分泌的药物,比如奥美拉唑和雷贝拉唑等,通过降低胃液的酸度,进而减少反流液体对食管的刺激。

另一种是促进食管蠕动的药物,比如潘立酮和莫沙必利等,这类药物增强了食管的蠕动性,使反流的胃液尽快回到胃里,从而降低对食管部位的刺激。

轻症患者单独用药就行,而重症患者需要联合用药治疗。如果是反复发作,发作时用药,好转后停药,这样可以有效减少服药量。

防范胃食管反流,生活习惯要调整

防范胃食管反流,首先每顿饭不能吃得太饱,不然会导致胃部压力增加,然后引起胃气上逆,从而出现反流,最理想的饱感应在7分-8分之间;其次要避免抽烟喝酒,抽烟会导致食管下段括约肌松弛,从而导致胃酸的反流,而喝酒则会导致食管清除酸性物质的能力下降。

除此之外还要避免肥胖,因为肥胖会增加腹部压力,更容易将胃部的食物和液体挤压上去。

再者,如果已经出现了胃食管反流,平时吃饭后不要立即躺卧,这样更容易引起反流。此外在睡觉的时候,尽量把头部垫高,这样食管处于高处,下段胃部反流的可能性就降低一些了。

原始出处:
[1]《胃食管反流会变脸!一亿人烧心、胸痛、腹痛都因它》.健康时报网.2019-2-22.
[2]《胃酸反流很常见,但它却让我父亲得了癌症》.果壳网.2019-5-29.
[3]《饭后反酸烧心?饮酒肥胖人群当心胃食管反流》.新京报.2020-1-19.

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    2021-11-27 ms3000001096233086

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  4. 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GetPortalCommentsPageByObjectIdResponse(id=1571698, encodeId=4a2915e169896, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Mon Sep 28 06:36:09 CST 2020, time=2020-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1601472, encodeId=8c1016014e298, content=<a href='/topic/show?id=5baa5299111' target=_blank style='color:#2F92EE;'>#患癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52991, encryptionId=5baa5299111, topicName=患癌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=888f18872716, createdName=lq0307, createdTime=Mon Sep 28 06:36:09 CST 2020, time=2020-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=888651, encodeId=1adb8886510b, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=02582767034, createdName=616049600, createdTime=Sun Sep 27 09:12:09 CST 2020, time=2020-09-27, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1074650, encodeId=3b4a10e4650e7, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5c455696426, createdName=ms3000001096233086, createdTime=Sat Nov 27 22:30:32 CST 2021, time=2021-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1059418, encodeId=4ecf1059418b2, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIa74YMTTyITk7FnAgtllnxJJIiapcJ9fmThVrptOsTm0s936moG0sJEhjUzaw9EQ2zIkxq5KQrkLg/0, createdBy=c7492141969, createdName=lrm45678, createdTime=Mon Oct 11 11:57:52 CST 2021, time=2021-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1948602, encodeId=85491948602de, content=<a href='/topic/show?id=87828339e7a' target=_blank style='color:#2F92EE;'>#胃食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83397, encryptionId=87828339e7a, topicName=胃食管)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=循证小兵, createdTime=Wed Jul 21 05:36:09 CST 2021, time=2021-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2061964, encodeId=837f20619645b, content=<a href='/topic/show?id=e6e1e15509f' target=_blank style='color:#2F92EE;'>#癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71550, encryptionId=e6e1e15509f, 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replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52999, encryptionId=3f225299942, topicName=患癌风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b2c2959841, createdName=zzc2212, createdTime=Mon Sep 28 06:36:09 CST 2020, time=2020-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437580, encodeId=9800143e58091, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Sep 28 06:36:09 CST 2020, time=2020-09-28, status=1, ipAttribution=), 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createdBy=888f18872716, createdName=lq0307, createdTime=Mon Sep 28 06:36:09 CST 2020, time=2020-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=888651, encodeId=1adb8886510b, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=02582767034, createdName=616049600, createdTime=Sun Sep 27 09:12:09 CST 2020, time=2020-09-27, status=1, ipAttribution=)]
    2020-09-28 zhouqu_8
  8. 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replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52999, encryptionId=3f225299942, topicName=患癌风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b2c2959841, createdName=zzc2212, createdTime=Mon Sep 28 06:36:09 CST 2020, time=2020-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437580, encodeId=9800143e58091, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Sep 28 06:36:09 CST 2020, time=2020-09-28, status=1, ipAttribution=), 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createdBy=888f18872716, createdName=lq0307, createdTime=Mon Sep 28 06:36:09 CST 2020, time=2020-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=888651, encodeId=1adb8886510b, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=02582767034, createdName=616049600, createdTime=Sun Sep 27 09:12:09 CST 2020, time=2020-09-27, status=1, ipAttribution=)]
    2020-09-28 feifers
  9. 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replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52999, encryptionId=3f225299942, topicName=患癌风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b2c2959841, createdName=zzc2212, createdTime=Mon Sep 28 06:36:09 CST 2020, time=2020-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437580, encodeId=9800143e58091, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Sep 28 06:36:09 CST 2020, time=2020-09-28, status=1, ipAttribution=), 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createdBy=888f18872716, createdName=lq0307, createdTime=Mon Sep 28 06:36:09 CST 2020, time=2020-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=888651, encodeId=1adb8886510b, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=02582767034, createdName=616049600, createdTime=Sun Sep 27 09:12:09 CST 2020, time=2020-09-27, status=1, ipAttribution=)]
    2020-09-28 lq0307
  10. 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    2020-09-27 616049600

    学习了

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