Current Gastroenterology Reports

, Volume 14, Issue 3, pp 181–188

Functional Heartburn: Definition and Management Strategies

Authors

    • Gastroenterology and Hepatology Department, Saint André HospitalCentre Hospitalier Universitaire de Bordeaux; Université Bordeaux Segalen
    • Gastroenterology DepartmentSaint Andre Hospital
  • Stanislas Bruley des Varannes
    • Institut des Maladies de l’Appareil DigestifCentre Hospitalier Universitaire de Nantes
  • Mireille Simon
    • Gastroenterology and Hepatology Department, Saint André HospitalCentre Hospitalier Universitaire de Bordeaux; Université Bordeaux Segalen
  • Jean Paul Galmiche
    • Institut des Maladies de l’Appareil DigestifCentre Hospitalier Universitaire de Nantes
Esophagus (MF Vela, Section Editor)

DOI: 10.1007/s11894-012-0255-7

Cite this article as:
Zerbib, F., Bruley des Varannes, S., Simon, M. et al. Curr Gastroenterol Rep (2012) 14: 181. doi:10.1007/s11894-012-0255-7

Abstract

Functional heartburn (FH) is a functional gastro-intestinal disorder characterized by symptoms of heartburn not related to gastro-esophageal reflux. The absence of evidence of reflux-related symptoms relies on absence of esophagitis at endoscopy (including biopsies to exclude eosinophilic esophagitis), a normal esophageal acid exposure during esophageal pH-monitoring together with a negative symptom-reflux association analysis and an unsatisfactory response to proton pump inhibitor therapy. Addition of impedance measurement to pH-monitoring is likely to increase the number of patients with recognized reflux-related symptoms. The pathophysiology of functional heartburn remains largely unknown but involves disturbed esophageal perception and psychological factors such as depression, anxiety and somatization. The treatment of FH remains largely empirical and an individual approach is therefore recommended. The clinician should provide reassurance and refrain from performing too many invasive tests or therapeutic procedures. The use of pain modulators is recommended by most experts despite the lack of appropriate clinical trials to support it.

Keywords

HeartburnFunctional esophageal disordersRome III classificationEsophageal sensitivityEsophageal impedanceEsophageal pH monitoringProton pump inhibitors

Copyright information

© Springer Science+Business Media, LLC 2012