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Functional heartburn: the stimulus, the pain, and the brain
  1. R Fass1,
  2. G Tougas2
  1. 1Department of Medicine, Section of Gastroenterology, Southern Arizona VA Health Care System and University of Arizona Health Sciences Center, Tucson, Arizona, USA
  2. 2Division of Gastroenterology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
  1. Dr R Fass, Southern Arizona VA Health Care System, Section of Gastroenterology, 1-111G-1, Tucson, AZ 85723, USA;


Functional heartburn is a common disorder and appears to be composed of several distinct subgroups. Identifying the different subgroups based on clinical history only is not achievable at present. The mechanisms responsible for pain, clinical characteristics, and the optimal therapeutic approach remain poorly understood. Response to potent antireflux treatment is relatively limited. Current and future treatment strategies for functional heartburn patients who have failed standard dose proton pump inhibitors (PPIs) include increased PPI dose in some, as well as addition of pain modulators in others.

  • gastro-oesophageal reflux disease
  • functional heartburn
  • non-erosive reflux disease
  • proton pump inhibitors
  • GORD, gastro-oesophageal reflux disease
  • NERD, non-erosive reflux disease
  • PPI, proton pump inhibitor
  • TLOSR, transient lower oesophageal sphincter relaxation
  • PET, positron emission tomography
  • FMRI, functional magnetic resonance imaging

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