Non-GORD | Delayed gastric emptying (common) Motility disorder: achalasia (common) Functional (common): normal reflux burden, no symptom/reflux correlation Aerophagia (less common) Rumination (less common) Eosinophilic oesophagitis (if dysphagia is present) |
Weakly acidic/non-acidic reflux | May occur after acid suppression in context of regurgitation due to mechanical failure (large hiatal hernia) |
Insufficient acidic suppression | Dosing (common) Compliance (common) Zollinger-Ellison syndrome (rare) PPI resistance (less common) |
Reflux sensitivity | Reflux burden is normal but patient has a clear symptom/reflux correlation. This is dependent on visceral hypersensitivity and hypervigilance |
PPI, proton pump inhibitor.