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Functional oesophageal disorders
Functional oesophageal disorders are a frequent cause of oesophageal symptoms. Patients are diagnosed as having a functional oesophageal disorder if they have normal standard oesophageal tests such as oesophageal manometry and reflux studies. Structural disorders, motility disorders with a histopathology basis and gastro-oesophageal reflux disease (GORD) are therefore excluded. A systematic and evidence-based approach to investigation, diagnosis and treatment is required. There are four functional oesophageal disorders defined by the Rome III consensus: functional heartburn, functional chest pain, functional dysphagia and globus. Despite the Rome diagnostic criteria for functional oesophageal disorders, the evidence base for many current therapies is not as robust. In this paper, we discuss the functional oesophageal disorders and their prevalence. We discuss diagnostic algorithms proposed by us and based on current evidence. We also discuss current therapies based on current evidence.