title: The Role of Esophageal Hypersensitivity in Functional Esophageal Disorders.
abstract: The Rome IV diagnostic criteria delineates 5 functional esophageal disorders which include functional chest pain, functional heartburn, reflux hypersensitivity, globus, and functional dysphagia. These are a heterogenous group of disorders which, despite having characteristic symptom profiles attributable to esophageal pathology, fail to demonstrate any structural, motility or inflammatory abnormalities on standard clinical testing. These disorders are associated with a marked reduction in patient quality of life, not least considerable healthcare resources. Furthermore, the pathophysiology of these disorders is incompletely understood. In this narrative review we provide the reader with an introductory primer to the structure and function of esophageal perception, including nociception that forms the basis of the putative mechanisms that may give rise to symptoms in functional esophageal disorders. We also discuss the provocative techniques and outcome measures by which esophageal hypersensitivity can be established.
authors.affiliation: *Department of Gastroenterology, University Hospitals of the North Midlands, Stoke on Trent ‡Centre for Trauma and Neuroscience, Blizard Institute, Wingate Institute of Neurogastroenterology, Barts and the London School of Medicine & Dentistry, Queen Mary University of London §Department of Surgery, Whipps Cross University Hospital, Barts Health NHS Trust, London UK †MechSense, Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Adam D
authors.initials: AD
authors.lastname: Farmer
authors.forename: James K
authors.initials: JK
authors.lastname: Ruffle
authors.forename: Qasim
authors.initials: Q
authors.lastname: Aziz
mesh_terms: D002637:Chest Pain / Q000209:etiology / Q000503:physiopathology; D003680:Deglutition Disorders / Q000209:etiology / Q000503:physiopathology; D004935:Esophageal Diseases / Q000209:etiology / Q000503:physiopathology*; D015154:Esophageal Motility Disorders / Q000209:etiology / Q000503:physiopathology*; D004947:Esophagus / Q000503:physiopathology*; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000503:physiopathology; D006356:Heartburn / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D006930:Hyperalgesia / Q000150:complications / Q000503:physiopathology*; D006967:Hypersensitivity / Q000150:complications / Q000503:physiopathology*