Distinction between patients with non-erosive reflux disease and functional heartburn.
Non-erosive reflux disease (NERD) and functional heartburn (FH) are two different clinical entities and the clear distinction between the two forms is actually possible thanks to the use of impedance-pH monitoring. NERD is the more common manifestation of gastro-esophageal reflux disease (GERD), one of the most widespread chronic gastrointestinal disorders in Western countries. The absence of visible lesions on endoscopy and the presence of troublesome reflux-associated (to acid, weakly acidic or non-acid reflux) symptoms are the two key factors for the definition of NERD. FH is an exclusive diagnosis and is defined by the Rome III criteria as a burning retrosternal discomfort, excluding GERD and esophageal motility disorders as a cause of the symptom. FH does not have any type of reflux underlying symptoms and psychological factors seem to be more expressed in FH patients than in patients with reflux-provoked disturbances. The aim of our review is to report the state-of-the-art knowledge about NERD and FH, to clarify their features and differences and to stimulate new research in this field.
Gastroenterology Unit, Departments of "Internal Medicine, University of Genoa (Maria Giacchino, Vincenzo Savarino), Genoa, Italy.
Maria
M
Giacchino
Gastroenterology Unit, Departments of "Internal Medicine, University of Genoa (Maria Giacchino, Vincenzo Savarino), Genoa, Italy.
Vincenzo
V
Savarino
Surgery, Oncology and Gastroenterology, University of Padua (Edoardo Savarino), Padua, Italy.
Edoardo
E
Savarino
Non-erosive reflux disease; PPI; esophageal impedance-pH monitoring; functional heartburn; gastro-esophageal reflux disease