Functional Heartburn is Gastroesophageal Reflux

Department of Pediatric Radiology of the 1-st State Hospital, Minsk, Belarus, Dorot. Medical Center for Rehabilitation and Geriatrics, Amnon veTamar, Netanya, Israel

*Corresponding author: Dr. Michael Levin, Department of Pediatric Radiology of the 1-st State Hospital, Minsk, Belarus, Dorot. Medical Center for Rehabilitation and Geriatrics, Amnon veTamar, Netanya, Israel, Tel: 972-538281393, E-mails: [email protected]; [email protected]

Received Date: March 06, 2025

Published Date: March 17, 2025

Citation: Levin M. (2025). Functional Heartburn is Gastroesophageal Reflux. Mathews J Gastroenterol Hepatol. 10(1):28.

Copyrights: Levin M. © (2025).

ABSTRACT

Most articles on the diagnosis and treatment of patients with GERD are based on recommendations from conferences participants that voted using the Delphi method. However, this method is intended for the organization of production and social planning, not for scientific analysis. This article analyzes two review articles on the differential diagnosis of GERD and functional heartburn. These diseases are not distinguishable by their clinical presentation. Differential diagnosis relies only on pH monitoring in the esophagus. In the presence of weakly acidic reflux (pH < 4 < 6% of the time out of 24 hours of recording), reflux is considered physiological, because of which GERD is excluded. These articles were published 5 years apart and the authors cite different conferences. As a result of the repeated voting, the definition of GERD was changed, and the diagnosis was now based only on pH monitoring and baseline impedance, if endoscopy did not reveal pathology. An analysis of the literature shows that pH monitoring detects only severe forms of GERD. In more than 30% of patients, the diagnosis of GERD is not confirmed, and they are unreasonably diagnosed with functional heartburn or other functional diseases. These patients do not receive timely pathogenetic treatment, which leads to chronicity of the process and severe complications. Voting participants, without scientific grounds, consider histological studies to be of little information to present pH monitoring as the gold standard in the diagnosis of GERD, which it is not. Conclusion. An analysis of these articles showed that the decisions of various conferences on the diagnosis and treatment of gastroesophageal reflux, made using the Delphi method, are not scientific. Their recommendations often contradict known scientific facts, contradict each other and sometimes to common sense. Because of using pH monitoring as a gold standard, which it is not, about two thirds of patients with GER are diagnosed with various supposedly functional diseases and they do not receive timely pathogenic treatment, which leads to chronicity of the process and severe complications. A free discussion is needed to eliminate contradictions in modern gastroenterology.

Keywords: Gastroesophageal Reflux Disease, Functional Heartburn, Delphi Method, Montreal Consensus, Lyon Consensus, Discussion.