Functional heartburn is defined as the presence of heartburn (retrosternal burning or pain) that is unrelated to oesophageal acid exposure and is not caused by gastro-oesophageal reflux.

Functional dyspepsia is characterised by predominant epigastric pain or burning (epigastric pain syndrome), or early satiety or discomfort after meals (postprandial distress syndrome).

• 🍒To diagnose functional heartburn or functional dyspepsia, symptoms must have been present for 6 months and investigated appropriately to exclude structural and metabolic causes
• [ ] Read eTG: approach to managing functional gastrointestinal disorders

An initial trial of proton pump inhibitor (PPI) therapy is appropriate to manage the symptoms of functional dyspepsia and heartburn

Functional heartburn should be suspected in patients with heartburn that persists despite PPI therapy