Published in:
01-04-2017 | Editorial
Psychological Comorbidity and Chronic Heartburn: Which Is the Chicken and Which Is the Egg?
Authors:
Ronnie Fass, Shira S. Fass
Published in:
Digestive Diseases and Sciences
|
Issue 4/2017
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Excerpt
During the last two decades, it has been recognized that patients reporting heartburn may not necessarily have gastroesophageal reflux disease (GERD) as the underlying cause of their symptoms [
1]. Heartburn does not appear to be stimulus-specific, since numerous stimuli may provoke this symptom [
2]. For example, either mechanical (intra-esophageal balloon distension) or chemical (mucosal acidification) can cause heartburn [
3]. This scientific breakthrough enabled research groups to identify new disorders in which heartburn was the predominant symptom, such as functional heartburn and reflux hypersensitivity, which are not GERD-related but instead are included in the category of functional esophageal disorders [
4]. Importantly, within the GERD group, there are 3 phenotypic presentations, all with heartburn as the predominant symptom: nonerosive reflux disease (NERD), erosive esophagitis, and Barrett’s esophagus [
5]. Thus, there are currently 5 accepted disorders (3 GERD-related and 2 functional esophageal disorders) in which heartburn is the principal symptom. …