反流(liu)(liu)(liu)性(xing)食管(guan)(guan)炎(yan)(yan)是由胃(wei)(wei)(wei)、十二指腸內容物反流(liu)(liu)(liu)入食管(guan)(guan)引起的(de)食管(guan)(guan)炎(yan)(yan)癥性(xing)病變,俗稱(cheng)“燒心(xin)病”,因為正常情況下胃(wei)(wei)(wei)酸只(zhi)存在于胃(wei)(wei)(wei)中,當反流(liu)(liu)(liu)入食管(guan)(guan)時灼燒或刺激食管(guan)(guan)而(er)產生“燒心(xin)感”。常常發生于飯后,因為食管(guan)(guan)括(kuo)約肌張力減(jian)弱或胃(wei)(wei)(wei)內壓力高于食管(guan)(guan)而(er)引起。該病經常與慢性(xing)胃(wei)(wei)(wei)炎(yan)(yan)、消化性(xing)潰(kui)瘍或食道裂孔疝(shan)等病并存,但也可(ke)單獨存在。
內(nei)鏡(jing)下表現為(wei)食(shi)(shi)管(guan)(guan)(guan)粘(zhan)膜(mo)的(de)(de)破損(sun)(sun),即食(shi)(shi)管(guan)(guan)(guan)糜(mi)爛和/或(huo)食(shi)(shi)管(guan)(guan)(guan)潰瘍。依據內(nei)鏡(jing)下食(shi)(shi)管(guan)(guan)(guan)粘(zhan)膜(mo)損(sun)(sun)傷的(de)(de)程度,將反流性食(shi)(shi)管(guan)(guan)(guan)炎(yan)分為(wei)A、B、C、D四級(ji)。A級(ji)食(shi)(shi)管(guan)(guan)(guan)炎(yan)是指食(shi)(shi)管(guan)(guan)(guan)黏(nian)膜(mo)的(de)(de)損(sun)(sun)傷局限于黏(nian)膜(mo)皺(zhou)襞,未(wei)融合(he);且糜(mi)爛的(de)(de)長度小(xiao)于5mm,B級(ji)食(shi)(shi)管(guan)(guan)(guan)炎(yan)的(de)(de)糜(mi)爛長度大于5mm;C級(ji)食(shi)(shi)管(guan)(guan)(guan)炎(yan)食(shi)(shi)管(guan)(guan)(guan)損(sun)(sun)傷有融合(he),但不超過食(shi)(shi)管(guan)(guan)(guan)環(huan)(huan)周的(de)(de)75%;D級(ji)食(shi)(shi)管(guan)(guan)(guan)炎(yan)指食(shi)(shi)管(guan)(guan)(guan)環(huan)(huan)周的(de)(de)黏(nian)膜(mo)損(sun)(sun)傷。
胃食(shi)(shi)管(guan)反流病(bing)患(huan)者中約有(you)40%表現為反流性(xing)食(shi)(shi)管(guan)炎。反流性(xing)食(shi)(shi)管(guan)炎可(ke)發生于(yu)任何年(nian)齡的(de)人(ren)群(qun),成人(ren)中發病(bing)率隨年(nian)齡增長而升(sheng)高。西(xi)方(fang)國家的(de)發病(bing)率高,而亞洲地(di)區發病(bing)率低。這種地(di)理學差異可(ke)能與遺傳和環(huan)境(jing)因(yin)素有(you)關。但近(jin)二十年(nian)全球的(de)發病(bing)率都有(you)上升(sheng)趨勢。中老年(nian)、肥胖、吸煙、飲酒及精神壓力大(da)是反流性(xing)食(shi)(shi)管(guan)炎的(de)高發人(ren)群(qun)。