Non-Erosive Reflux Disease (NERD) and Functional Heartburn

  • E. M. M. Quigley


NERD is a real entity and its importance in the spectrum of GERD must be appreciated. Functional heartburn needs to be further differentiated as that subgroup of patients in which there appears to be no relationship between symptoms, albeit “typical” of GERD, and acid exposure. Several aspects of NERD need to be appreciated including the overlap with functional dyspepsia and potential differences in response to such therapeutic interventions as acid suppressive therapy and fundoplication. While definitive studies on this issue are yet to be completed, it remains quite possible that our failure to separate functional heartburn from NERD, in general, has contributed in large measure to diagnostic difficulties and therapeutic disappointment in GERD. This author contends that functional heartburn should be removed from the spectrum of GERD and relocated to the functional gastrointestinal disorders; only then will effective approaches to the assessment and therapy of this challenging disorder emerge.


Irritable Bowel Syndrome Functional Dyspepsia Acid Exposure GERD Patient Esophageal Acid Exposure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Authors and Affiliations

  • E. M. M. Quigley
    • 1
  1. 1.Head of the Medical SchoolNational University of IrelandCorkIreland

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