Aspectos menos conocidos de la enfermedad por reflujo gastroesofágico: pirosis funcional y reflujo no ácido

Gastroesophageal reflux disease (GERD) is defined as a pathologic condition that develops when reflux of stomach contents produce annoying symptoms and/or complications. According to whether esophagitis is present, GERD is classified as being erosive and non-erosive. Functional pyrosis is defined by the presence of retrosternal burning for at least 6 months in the absence of structural or metabolic alterations, GERD, or motor disorders that could cause the symptoms. Currently, functional pyrosis does not include patients with an acid-sensitive esophagus or those who improve with antisecretory drugs, which differentiates this entity from non-erosive GERD. GERD has usually been identified with acid reflux. However, the availability of new diagnostic methods such as Bilitec® and, especially, impedance monitoring has revealed that acid, weakly acidic and gas reflux is able to produce distressing symptoms and complications in some patients.