by Allison Lindstrom, NP
Functional heartburn consists of burning behind the sternum similar to that experienced in gastroesophageal reflux disease (GERD), but without evidence of abnormal pH (proving acidity reaches the esophagus throughout the day) testing, major esophageal motor disorders discovered during pressure testing(achalasia), or esophageal mucosal abnormality during endoscopy. The latter test excludes Barrett’s esophagus, EOE, and reflux disease. It is suspected that functional heartburn is present in 21-39% of patients with heartburn who are not responsive to proton pump inhibitors (PPI). There is also a high likelihood of anxiety in patients with functional heartburn. For that reason, treatment of functional heartburn- once the diagnosis has been established by your gastrointestinal provider- usually consists of decreasing nerve sensitivity by medications used to treat anxiety/depression, acupuncture, hypnotherapy, or melatonin. Ranitidine, which is also an acid suppressing medication, has been shown to be helpful by modifying pain thresholds. Understanding functional heartburn and completing suggested work up is very important not only for the patient, but the provider, as escalating treatment with acid suppressing medications will likely be futile and may cause harm long term.
If you have been struggling with reflux symptoms or have tried an over the counter medication without relief for your symptoms, please call our office at 224-407-4400 to begin the conversation with a provider as an underlying organic cause could be the source of your complaints, as could functional heartburn. #heartburn #functionalheartburn #GERD
Fass R, Zerbib F, Gyawali CP. AGA Clinical Practice Update on Functional Heartburn: Expert Review. Gastroenterology. 2020 Jun;158(8):2286-2293. doi: 10.1053/j.gastro.2020.01.034. Epub 2020 Feb 1. PMID: 32017911.