Functional esophageal disorders: a review of diagnosis and management

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Date: July 2013
Publisher: Expert Reviews Ltd.
Document Type: Disease/Disorder overview
Length: 4,921 words
Lexile Measure: 1430L

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Author(s): Anand R Kumar [*] 2 , Philip O Katz 1



chest pain; diagnosis; dysphagia; esophageal; functional; gastroesophageal reflux disease; globus; heartburn; noncardiac chest pain; treatment

Medscape: Continuing Medical Education Online

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and Expert Reviews Ltd. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians.

Medscape, LLC designates this Journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s) [trademark] . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 70% minimum passing score and complete the evaluation at; (4) view/print certificate.

Release date: 31 July 2013; Expiration date: 31 July 2014

Learning objectives

Upon completion of this activity, participants will be able to:

* Define and describe various types of functional esophageal disorders, based on a review

* Describe the diagnosis and management of functional esophageal disorders, based on a review

Financial & competing interests disclosure


Elizabeth Knowles

Publisher, Informa Healthcare, London, United Kingdom

Disclosure: Elizabeth Knowles has disclosed no relevant financial relationships .


Laurie Barclay, MD

Freelance writer and reviewer, Medscape, LLC

Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships .


Anand R Kumar

Department of Gastroenterology, Einstein Medical Center, Philadelphia, PA 19141, USA

Disclosure: Anand R Kumar has disclosed no relevant financial relationships .

Philip O Katz

Department of Gastroenterology, Einstein Medical Center, Philadelphia, PA 19141, USA

Disclosure: Philip O Katz has disclosed no relevant financial relationships .

Scientific advances in the last two decades have given us a number of tools to understand esophageal symptoms. In addition to a good history and well-performed upper endoscopy, the two key diagnostic tests used in the evaluation of esophageal symptoms that the authors will describe in the following discussion are reflux monitoring (prolonged telemetry capsule pH monitoring and 24-h impedance pH testing) and the manometry study. The authors will also discuss the clinical value of the more controversial symptom association analyses associated with these tests. A thorough clinical history usually helps distinguish the more common milder illness from a rare life-threatening disorder although both may have the same presenting symptom; for example, dysphagia.

The key to dealing with esophageal symptoms is to differentiate whether the patient's symptoms are due to gastroesophageal reflux disease (GERD), esophageal motility abnormalities or functional symptoms. At one point, six conditions were categorized as functional esophageal disorders [1] . Subsequently, it was revised to include four major esophageal symptoms of heartburn, chest pain, dysphagia and globus sensation [2,3] . This report is aimed at summarizing the available evidence related to treating functional esophageal disorders. A brief overview of the diagnostic process outlined in Rome...

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Source Citation   

Gale Document Number: GALE|A339495921