GASTROENTEROLOGY ARTICLE OF THE WEEK
May 3, 2007
Galmiche JP, Cluse RE, Balint A, et al. Functional esophageal disorders. Gastroenterology 2006;130:1459-1465
1. For a patient to be classified as having a functional esophageal disorder, the following parameters should be present
a. symptoms lasting 1-3 months
b. no evidence of motor disorders
c. normal EGD
d. a normal 24 hour pH study regardless of symptom index
True or False
2. Acute stress enhances perception of esophageal acid without increasing reflux events
3. A lack of response to high dosages of PPI has a high negative predictive value for GERD
4. Acid-related chest pain syndrome is usually related to erosive esophagitis, a normal endoscopy greatly reduces the likelihood that pain is due to acid
5. Globus is more common in females
6. Patients with functional chest pain syndrome usually improve after other etiologies are excluded and the patient is reassured
7. Globus is usually associated with the presence of a crycopharyngeal bar
8. Antidepressants (TCA or SSRI’s) may be of benefit for functional chest pain syndrome even in the absence of obvious depression
9. Functional dysphagia is synonymous with globus sensation
10. A patient with a history suggestive of globus should have an expert ENT exam