J Neurogastroenterol Motil.  2017 Oct;23(4):495-503. 10.5056/jnm17097.

Reflux Hypersensitivity: A New Functional Esophageal Disorder

• Yamasaki T
• Fass R

• KMID: 2395417
• DOI: http://doi.org/10.5056/jnm17097

Abstract

Reflux hypersensitivity, recently introduced by Rome IV as a new functional esophageal disorder, is currently considered as the presence of typical heartburn symptoms in patients with normal upper endoscopy and esophageal biopsies, normal esophageal pH test and with evidence of a close correlation between patients' heartburn and reflux events. Reflux hypersensitivity is very common and together with functional heartburn accounts for more than 90% of the heartburn patients who failed treatment with proton pump inhibitor twice daily. In addition, reflux hypersensitivity affects primarily young to middle aged women, commonly overlaps with another functional gastrointestinal disorders, and is often associated with some type of psychological comorbidity. Diagnosis is made by using endoscopy with esophageal biopsies, pH-impedance, and high-resolution esophageal manometry. Reflux hypersensitivity is primarily treated with esophageal neuromodulators, such as tricyclic anti-depressants and selective serotonin reuptake inhibitors among others. Surgical anti-reflux management may also play an important role in the treatment of reflux hypersensitivity.

Keyword

Chest pain; Esophagus; Functional esophageal disorder; Heartburn; Reflux hypersensitivity

MeSH Terms

Biopsy
Chest Pain
Comorbidity
Diagnosis
Endoscopy
Esophagus
Female
Gastrointestinal Diseases
Heartburn
Humans
Hydrogen-Ion Concentration
Hypersensitivity*
Manometry
Middle Aged
Neurotransmitter Agents
Proton Pumps
Serotonin Uptake Inhibitors
Neurotransmitter Agents
Proton Pumps
Serotonin Uptake Inhibitors