Standards und Innovationen in der Diagnostik der gastroösophagealen Refluxkrankheit

Zusammenfassung

Die gastroösophageale Refluxkrankheit (GERD) nimmt eine zentrale Rolle in der Patientenversorgung ein. Ein Großteil der Patienten, vor allem in den westlichen Industriestaaten, leidet an Symptomen einer Refluxkrankheit. Der Artikel gibt eine Übersicht über die wichtigsten Verfahren zur Diagnostik der GERD. Standardverfahren wie pH-Metrie, Bilitec und Manometrie, aber auch neue diagnostische Verfahren wie die Impedanzmessung und die Bravo pH-Metrie werden in Funktion und Anwendung beschrieben. Auch endoskopische Standards und neue Verfahren wie Chromo- und Magnifikationsendokopie, narrow band imanging (NBI) und computed virtual chromoendoscopy (CVC) werden dargestellt. Nicht alle, dieser teilweise neuen Verfahren müssen bei jedem Patienten Anwendung finden. Vielmehr erachten wir es für sinnvoll, die Untersuchungsmethoden, deren Vor- und Nachteile, genau zu kennen. Nur so ist es möglich, sie gezielt einzusetzen. Ziel der Untersuchungen ist die Charakterisierung der GERD bei dem jeweiligen Patienten, um eine gezielte Therapie anwenden zu können.

Abstract

Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal diseases in the world. This article gives an overwiew about diagnostic procedures for GERD. Standard procedures such as pH-metry, Bilitec and manometry and also new diagnostic tools such as combined multichannel intraluminal impedance (MII) and pH-metry and Bravo Capsule are described in detail. Established endoscopy criteria as well as innovative techniques such as magnification, narrow band imaging and computed virtual chromoendoscopy are also presented. Not all of these procedures need to be used in every patient. Therefore, it is important to know the technical aspects, indications, advantages and disadvantages of each method in order to appropriately use any of these tests. The final goal is to characterise GERD and provide the patient with an appropriate therapy.

Schlüsselwörter

GERD - pH-Metrie - Bilitec - Bravo MII-pH - Impedanz - MII-pH - Endoskopie

Key words

GERD - pH-metry - Bilitec - Bravo MII-pH - Impedance - MII-pH - endoscopy

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