PMID- 16009029
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20060123
LR  - 20200929
IS  - 1092-8472 (Print)
IS  - 1092-8472 (Linking)
VI  - 8
IP  - 4
DP  - 2005 Aug
TI  - Functional heartburn.
PG  - 285-91
AB  - Functional heartburn (FH) is a common disorder that accounts for 30% to 50% of 
      the patients with nonerosive reflux disease. FH is composed from a heterogeneous 
      group of patients. They primarily include the hypersensitive and the nonacid 
      sensitive esophagus. The mechanisms responsible for pain, clinical 
      characteristics, and the optimal therapeutic approach of FH remain to be fully 
      elucidated. Symptom response rate to potent antireflux treatment is significantly 
      lower in FH patients as compared with any other gastroesophageal reflux disease 
      (GERD) group, suggesting that in proton pump inhibitor (PPI) non-responders 
      mechanisms other than acid reflux are likely the cause of symptoms. Patients with 
      FH should be approached therapeutically as patients with GERD and should 
      initially receive antireflux medications. Due to the need for profound acid 
      suppression in this group of patients, PPIs should be considered relatively early 
      in their care. Failure to respond to standard dosage of PPI is common and will 
      require doubling the dose. If patients continue to report heartburn symptoms 
      while receiving PPI twice daily, adding or switching to pain modulators/visceral 
      analgesics is an appropriate therapeutic approach. Data about the usage of other 
      therapeutic modalities in FH such as antireflux surgery, endoscopic treatment for 
      GERD, and psychotherapy are still unavailable. Emerging treatment will likely 
      include novel pain modulators and more effective antireflux medications.
FAU - Dickman, Ram
AU  - Dickman R
AD  - GI Section (1-111G-1), Southern Arizona VA Health Care System, 3601 South 6th 
      Avenue, Tucson, Arizona 85723-0001, USA.
FAU - Fass, Ronnie
AU  - Fass R
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Curr Treat Options Gastroenterol
JT  - Current treatment options in gastroenterology
JID - 9815941
EDAT- 2005/07/13 09:00
MHDA- 2005/07/13 09:01
CRDT- 2005/07/13 09:00
PHST- 2005/07/13 09:00 [pubmed]
PHST- 2005/07/13 09:01 [medline]
PHST- 2005/07/13 09:00 [entrez]
AID - 10.1007/s11938-005-0021-0 [doi]
PST - ppublish
SO  - Curr Treat Options Gastroenterol. 2005 Aug;8(4):285-91. doi: 
      10.1007/s11938-005-0021-0.