查看更多>>摘要：Heartburn is among the most common gastrointestinal symptoms presenting to both generalist physicians and gastroenterologists. In the era of high utilization of proton pump inhibitors, a substantial proportion of patients presenting to the gastroenterologist with chronic symptoms of heartburn do not have a reflux-mediated disease. Subjects without objective evidence of reflux as a cause of their symptoms have functional heartburn (FH). FH has no evidence of abnormal esophageal acid exposure on ambulatory reflux monitoring, major esophageal motor disorders on high resolution manometry, or esophageal mucosal pathology, such as eosinophilic esophagitis on endoscopy with esophageal biopsies. The pathophysiology of FH is unknown but it is often associated with visceral hypersensitivity, and psychiatric disease. Importantly, anti-reflux surgery or other invasive anti-reflux modalities should be avoided. Although there are limited supporting data, modulation of pain perception, traditional Chinese medicine and psychological intervention may be potential therapeutic options in this population.
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