Some heartburn can be caused by structural or biochemical abnormalities, but other individuals with heartburn have no such abnormalities — those individuals may have what is called functional heartburn. In addition to the burning pain in chest and throat, other symptoms include belching, regurgitation and bloating. People with functional heartburn typically do not respond to medications used to treat GERD.
Advances in the field, such as esophageal pH-impedance testing, now allow for better diagnosis and characterization for patients presenting with heartburn. These advanced have highlighted the inadequacy of one-size-fits-all treatments such as modifying diets and trial PPI therapy. Seventy-five percent of patients with functional heartburn also have esophageal hypersensitivity, which means they experience the symptoms more strongly than most people — making the symptoms even more frequent and painful.
Studies have also shown a link between stress and functional heartburn. Continue reading