Overlap of functional heartburn and gastroesophageal reflux disease with irritable bowel syndrome  

作　　者：Nicola de Bortoli Irene Martinucci Massimo Bellini Edoardo Savarino Vincenzo Savarino Corrado Blandizzi Santino Marchi 

机构地区：[1]Division of Gastroenterology, University of Pisa [2]Division of Gastroenterology, University of Padua [3]Division of Gastroenterology, University of Genoa [4]Division of Pharmacology and Chemotherapy, University of Pisa

出　　处：《World Journal of Gastroenterology》2013年第35期5787-5797,共11页世界胃肠病学杂志（英文版）

摘　　要：Several studies indicate a significant degree of overlap between irritable bowel syndrome(IBS)and gastroesophageal reflux disease(GERD).Likewise,both functional heartburn(FH)and IBS are functional digestive disorders that may occur in the same patients.However,data establishing a solid link between FH and IBS are lacking,mainly because the clinical definition of FH has undergone substantial changes over the years.The available literature on the overlap between GERD or FH and IBS highlights considerable heterogeneity in terms of the criteria and diagnostic procedures used to assess heartburn and IBS.In particular,several epidemiological studies included patients with concomitant IBS and GERD without any attempt to distinguish FH(as defined by the RomeⅢcriteria)from GERD via pathophysiological investigations.Independent of these critical issues,there is preliminary evidence supporting a significantdegree of FH-IBS overlap.This underscores the need for studies based on updated diagnostic criteria and accurate pathophysiological classifications,particularly to distinguish FH from GERD.This distinction would represent an essential starting point to achieving a better understanding of pathophysiology in the subclasses of patients with GERD and FH and properly assessing the different degrees of overlap between IBS and the subcategories of heartburn.The present review article intends to appraise and critically discuss current evidence supporting a possible concomitance of GERD or FH with IBS in the same patients and to highlight the pathophysiological relationships between these disorders.Several studies indicate a significant degree of overlap between irritable bowel syndrome(IBS) and gastroesophageal reflux disease(GERD). Likewise, both functional heartburn(FH) and IBS are functional digestive disorders that may occur in the same patients. However, data establishing a solid link between FH and IBS are lacking, mainly because the clinical definition of FH has undergone substantial changes over the years. The available literature on the overlap between GERD or FH and IBS highlights considerable heterogeneity in terms of the criteria and diagnostic procedures used to assess heartburn and IBS. In particular, several epidemiological studies included patients with concomitant IBS and GERD without any attempt to distinguish FH(as defined by the Rome Ⅲ criteria) from GERD via pathophysiological investigations. Independent of these critical issues,there is preliminary evidence supporting a significantdegree of FH-IBS overlap. This underscores the need for studies based on updated diagnostic criteria and accurate pathophysiological classifications, particularly to distinguish FH from GERD. This distinction would represent an essential starting point to achieving a better understanding of pathophysiology in the subclasses of patients with GERD and FH and properly assessing the different degrees of overlap between IBS and the subcategories of heartburn.The present review article intends to appraise and critically discuss current evidence supporting a possible concomitance of GERD or FH with IBS in the same patients and to highlight the pathophysiological relationships between these disorders.

关 键 词：Functional gastrointestinal disorders GASTROESOPHAGEAL REFLUX disease/Gastro-oesophageal REFLUX DISEASE IRRITABLE bowel syndrome Acidity(esophageal) HYPERSENSITIVITY 

分 类 号：R571[医药卫生—消化系统] R574[医药卫生—内科学]