Esophageal Reflux Hypersensitivity: A Comprehensive Review

Reflux hypersensitivity (RH) is one of the phenotypes of gastroesophageal reflux disease. The latest Rome IV defines RH as a condition with typical reflux symptoms and positive reflux-symptom association despite normal acid exposure. Subsequently, the Lyon consensus proposed detailed cutoff values for the criteria on the basis of experts' consensus. Rome IV brought a clear-cut perspective into the pathophysiology of gastroesophageal reflux disease and the importance of esophageal hypersensitivity. This perspective can be supported by the fact that other functional gastrointestinal disorders such as irritable bowel syndrome and functional dyspepsia often overlap with RH. Although several possible pathophysiological mechanisms of esophageal hypersensitivity have been identified, there is still unmet medical needs in terms of treatment for this condition. This review summarizes the current knowledge regarding RH. (Gut Liver, Published online January 2, 2023)

Automated summary

Reflux hypersensitivity (RH) is a phenotype of gastroesophageal reflux disease characterized by typical reflux symptoms and positive reflux-symptom association despite normal acid exposure. The Rome IV criteria and Lyon consensus provided a clearer understanding of the pathophysiology and importance of esophageal hypersensitivity. RH often overlaps with other functional gastrointestinal disorders. Despite identified pathophysiological mechanisms, there is still a need for improved treatment options. This review provides a summary of current knowledge on RH. (Gut Liver, Published online January 2, 2023)