Pathophysiology of functional heartburn based on Rome III criteria in Japanese patients

Table 1 Clinical characteristics

Characteristic	pH-POS	HE	FH	P value
	(n = 22)	(n = 34)	(n = 22)
Age, yr	54.8 ± 3.9	54.9 ± 2.6	57.7 ± 2.7	0.3
	(26–80)	(21–86)	(29–76)
Sex, male:female	14:08	17:17	9:13	0.3
Body mass index, kg/m2	21.9 ± 3.5	22.0 ± 3.0	21.3 ± 2.7	0.6
Drinking	8 (36.3)	16 (47.0)	8 (36.3)	0.4
Smoking	7 (31.8)	10 (29.4)	5 (22.7)	0.7
Neuroticism (III or IV)1	4 (22.7)	8 (23.5)	5 (22.7)	0.8

Data are expressed as mean ± SD (range), or as n (%), unless otherwise indicated;

¹Neuroticism was defined using the Cornel Medical Index. P-values were obtained using the Kruskal-Wallis or χ² tests. FH: Functional heartburn; HE: Hypersensitive esophagus (non-excessive esophageal acid exposure time and positive symptom index); pH-POS: Excessive intraesophageal acid exposure time.

Table 2 Questionnaire scores

Questionnaire	pH-POS	HE	FH	P value1
	(n = 22)	(n = 34)	(n = 22)
FSSG score (median)	16.4 ± 7.2	18.4 ± 9.6	19.5 ± 10.3	0.6
QUEST score (median)	5.8 ± 4.7	5.1 ± 4.5	4.2 ± 4.2	0.5
GSRS scale
Over all	2.5 ± 0.6	2.5 ± 0.8	2.2 ± 1.0	0.5
Acid reflux	3.4 ± 1.6	3.2 ± 1.5	3.0 ± 1.4	0.7
Abdominal pain	2.5 ± 1.1	2.4 ± 1.3	2.3 ± 1.3	0.7
Indigestion	2.9 ± 1.8	2.8 ± 1.1	2.5 ± 1.4	0.5
Diarrhea	1.6 ± 0.7	1.9 ± 1.2	1.7 ± 0.1	0.8
Constipation	2.3 ± 1.4	2.4 ± 1.2	2.0 ± 1.1	0.3
SF-36 scale
Physical Functioning	46.5 ± 11.1	45.1 ± 16.2	44.7 ± 16.1	0.9
Role Physical	40.5 ± 13.2	41.0 ± 15.4	40.4 ± 15.1	0.9
Bodily Pain	43.6 ± 9.1	44.1 ± 10.1	43.5 ± 11.8	0.9
General Health	38.9 ± 9.8	42.1 ± 6.3	43.1 ± 10.5	0.5
Vitality	46.0 ± 10.6	45.5 ± 9.5	45.4 ± 11.1	0.9
Social Functioning	44.8 ± 10.6	39.2 ± 13.1	44.6 ± 11.2	0.2
Role Emotional	41.9 ± 14.3	42.5 ± 14.3	44.6 ± 14.2	0.8
Mental Health	43.9 ± 10.5	42.2 ± 11.0	41.8 ± 13.8	0.9

¹Determined by the Kruskal-Wallis test; Data are expressed as mean ± SD unless otherwise indicated. FH: Functional heartburn; FSSG: Frequency scale for the symptoms of gastroesophageal reflux disease; GSRS: Gastrointestinal symptoms rating scale; HE: Hypersensitive esophagus (non-excessive esophageal acid exposure time and positive symptom index); pH-POS: Excessive intraesophageal acid exposure time; QUEST: Questionnaire for the diagnosis of reflux disease.

Table 3 Twenty-four-hour intraesophageal pH-multichannel intraluminal impedance testing

Variable	pH-POS (n = 22)	HE (n = 34)	FH (n = 22)	P value1
% acid exposure time	16.1 ± 15.3b	1.4 ± 2.4	0.7 ± 0.8	< 0.01
Number of reflux episodes	77.8 ± 40.6b	54.6 ± 30.3	33.9 ± 20.8	< 0.01
Acid reflux (pH < 4)	34.1 ± 23.7b	11.2 ± 11.1	7.1 ± 6.3	< 0.01
Non-acid reflux (pH ≥ 4)	41.0 ± 35.1	37.7 ± 32.2	23.8 ± 17.3	0.2
Number of proximal reflux episodes	34.4 ± 26.7b	22.2 ± 12.5	14.1 ± 9.0	< 0.01
% of proximal reflux Episodes	42.5 ± 14.3	42.5 ± 13.3	41.4 ± 14.3	0.9
% of gastric acid exposure time	66.1 ± 20.5	50.6 ± 30.9	49.9 ± 28.7	0.1

¹Determined by the Kruskal-Wallis test;

^bP < 0.01 vs HE and FH. FH: Functional heartburn; HE: Hypersensitive esophagus (non-excessive esophageal acid exposure time and positive symptom index); pH-POS: Excessive intraesophageal acid exposure time.