Summary
Introduction. Gastroesophageal reflux disease (GERD) is a chronic condition characterized by acidic gastric contents reflux to the esoph a gus resulting in clinical symp toms and/or visible oe soph a geal mucosal damage and complications. The most common form of GERD is non-ero - sive esoph a geal reflux disease (NERD). Clinically and phenotypically, it is very similar to the functional oesophageal disorders defined by Rome IV criteria: reflux hypersensitivity and functional heartburn. Ambulatorical 24-hour oe soph ageal pH-metry and impedansometry helps to differentiate these conditions, but there is still no confirmed diagnostic standard. The number of ongoing clinical trials on new endoscopic diagnostic modules, which would al low better differentiation be tween the GERD and func tional esoph a geal disorders in clinical practice, is increasing. Proton pump inhibitors, which are empirically prescribed for the treatment of NERD, are not effective for functional heart burn.
Objective. To review the recent literature on clinical differences, diagnosis, and treatment options of NERD, esophageal reflux hypersensitivity and functional heart - burn.
Methods. The literature search was performed using PubMed, Medscape, Cochrane Library, UpToDate and Google Scholar.
Conclusions. GERD and functional oe soph a geal disorders present with similar symptoms, basically heart burn and regurgitation. The main diagnostic method to differentiate GERD, esophageal reflux hypersensitivity and functional heart burn is ambulatorical 24-hour pH-metry. Image-enhanced endoscopy may also be useful for the diagnosis of these conditions. The aim of prescribing treatment is not to cure but to reduce the symptoms and improve quality of life. Proton pump inhibitors are commonly prescribed for patients with reflux symptoms, but in cases of functional oesophageal disorders, this treatment is often ineffective. There fore, neuromodulators must beconsidered.
