Functional gastrointestinal disorders: focus on the differential diagnosis of heartburn

The article presents data on changes in the concept of functional gastrointestinal disorders, introduced by the Rome IV criteria, in particular, the tendency to abandon the term “functional" due to the fact that it does not correspond to the modern model of the pathogenesis of functional gastrointestinal disorders (FGIDs), which is based on disorders of the interaction of the brain and the gastrointestinal tract. Changes in the classification of FGIDs are discussed - the inclusion of new nosological units: opioid-induced gastrointestinal hyperalgesia, opioid-induced constipation, cannabinoid-induced vomiting syndrome, nausea and vomiting syndrome, combining chronic idiopathic nausea and functional vomiting, reflux hypersensitivity previously considered as a variant of nonerosive reflux disease is added in the Section “esophageal function disorders". In addition, the expert council of the Rome IV Consensus revised the approach to the diagnosis and treatment of patients with sphincter of Oddi dysfunction. Particular attention is paid to the differential diagnosis between functional heartburn and reflux hypersensitivity, with daily intraesophageal pH-impedancemetry as the most important diagnostic test. The issue of differential diagnosis between the FGIDs and somatoform autonomic dysfunction is separately considered.

functional gastrointestinal disorders, functional heartburn, reflux hypersensitivity, Rome IV criteria