For patients with symptoms similar to gastroesophageal reflux disease(GERD)(GERD-like symptoms)and negative esophageal mucosa or structure under endoscopy,there is significant heterogeneity in the selection of clinical diagnosis and treatment plans,and the differences in esophageal motility and anti-reflux barrier function among different diagnostic types are still unclear.With the promulgation of the Rome IV standard for functional gastrointestinal diseases,the diagnostic types of endoscopy-negative patients with typical GERD-like symptoms include non-erosive reflux disease(NERD),reflux hypersensitivity(RH)and functional heartburn(FH).This paper summarizes research progress in the pathogenesis and pathophysiological changes among different diagnostic types,providing new ideas for distinguishing functional esophageal diseases and screening out true GERD in clinical practice.
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