| Theme |
GERD -- Recent Clinical Advances |
| Title |
Functional Heartburnin RomeIII |
| Author |
Michio Hongo |
Department of Comprehensive Medicine, Department of Psychosomatic Medicine, Tohoku University Hospital |
| Author |
Tomotaka Shoji |
Department of Psychosomatic Medicine, Tohoku University Hospital |
| Author |
Miho Tsutsui |
Department of Comprehensive Medicine, Tohoku University Hospital |
| [ Summary ] |
In patients with heartburn with normal endoscopic findings, a variety of types of pathogenesis related to symptom development is found. The forms of pathogenesis are as follows; 1) strong acid reflux, 2) weak acid reflux, 3) non-acid liquid reflux, 4) gas reflux, and 5) no-reflux associated symptoms. According to definition, strong acid reflux is directly related to induction of heartburn symptoms. Heartburn symptoms may be induced by weak acid reflux, non-acid liquid reflux or gas reflux through chemical sensitization and/or mechanical distention of the esophagus by the refluxate. These states may be diagnosed across the spectrum of non-erosive reflux diseases(NERD). Those who have heartburn symptoms not related to any reflux events should be classified as having functional heartburn. Those patients are non-responsive to acid inhibition therapy or anti-reflux procedures. Further studies are required to clarify the mechanisms of heartburn symptom development. |