Heartburn in view of Rome IV criteria
Simanenkov V.I., Tikhonov S.V., Lishchuk N.B.

North-West State Medical University named after I.I. Mechnikov, St. Petersburg

Heartburn is one of the most common somatic symptoms. In the Russian Federation it occurs in 40% of people aged from18 to 59 years and in 30% of the population over the age of 60. The article examines in detail the pathophysiology of heartburn in patients with reflux esophagitis (RE) and non-erosive reflux disease (NERD), in which pathological conditions such as hypersensitive esophagus (HE) or functional heartburn (PH) can be detected. The microscopic study of the mucosa of the distal esophagus is used to diagnose and distinguish between gastroesophageal reflux disease (GERD) and HE from PH. To diagnose the causes of heartburn, FGDS and daily pH-impedance measurements are made. According to the Roman criteria, the IV group of functional disorders of the esophagus includes: functional pain in the chest, FI, HE, globus pharyngeus and functional dysphagia. 
In patients with RE, NERD, HE the acid-suppressive therapy is highly effective, especially when using the modern PPIs. A peculiarity of the PPI of dexlansoprazole is the dextrorotatory isomer that is more favorable from the pharmacokinetic and pharmacodynamic point of view. However, in patients with PH the PPIs can be ineffective, in this case it is necessary to give preference to the drugs that reduce visceral hypersensitivity.

Key words: heartburn, GERD, reflux esophagitis, hypersensitive esophagus, PPI, dexlansoprazole.
For citation: Simanenkov V.I., Tikhonov S.V., Lishchuk N.B. Heartburn in view of Rome IV criteria // RMJ. 2017. № 10. P. 691–696.