TY - JOUR T1 - Digest JF - Gut JO - Gut SP - i LP - ii DO - 10.1136/gut.2009.193219 VL - 58 IS - 9 A2 - Spiller, Robin Vermeire, Severine Y1 - 2009/09/01 UR - http://gut.bmj.com/content/58/9/i.abstract N2 - Non-erosive reflux disease (NERD) is the commonest form of reflux, which in some cases is associated with increased acid exposure of the distal oesophagus (NERD pH-POS). Patients with symptoms but normal acid exposure include those with hypersensitive oesophagus with a positive symptom association probability and other cases where there appears to be no temporal link between acid exposure and symptoms. These so called “functional heartburn” (FH) cases are the subject of this study of 200 patients with NERD. Eighty-one patients (41%) had excessive acid exposure, 119 (59%) had normal acid exposure, of which 65 (32%) had hypersensitive oesophagus and 54 (27%) had FH. Patients with FH were more likely to be female (68%) compared with NERD pH-POS (41%) and were characterised by increased prevalence of functional dyspeptic symptoms, including postprandial fullness, early satiety, bloating and nausea (see fig). The proportion of patients with FH reporting a positive response to proton pump inhibitor (PPI) therapy at 29% was significantly lower than the 74% in NERD pH-POS patients. Identifying such patients by their associated dyspeptic symptoms is important since it can avoid fruitless PPI therapy and unnecessary, potentially harmful surgery.See page 1185Prevalence of dyspeptic symptoms in functional heartburn patients (NERD pH-NEG/SAP-).Salmonella typhimurium infection is one of the commonest causes of gastroenteritis worldwide. While children get more diarrhoea, they are less likely to die from infection than the elderly. The associated colonic secretion is driven by the neuropeptide galanin, one … ER -