Peter Sabaka, Ľudovít Lukáč
An oesophagal hypersensitivity is a state, in which physiologic stimuli like physiologic reflux leads to the perception of
pain. Diseases associated with the oesophagal hypersensitivity are a hypersensitive oesophagus and a functional pyrosis.
These diseases are quite common, and their most common presentations are a noncardiac chest pain and pyrosis
resistant to proton pump inhibitors. Their pathogenesis is not yet clearly understood but is probably associated with
increased perception of oesophageal mucosa caused by excessive receptor expression or activation or excessive signal
transduction on the level of the central nervous system. Differential diagnosis of the oesophagal hypersensitivity is
based on ruling out of the gastroesophageal reflux disease and morphologic and motoric disorders of the oesophagus
and on an impedance and pH monitoring. Therapeutic options are quite limited. Drugs that modulates visceral sensitivity
like antidepressants, theophylline or transient lower oesophagal sphincter relaxation inhibitor baclofen are often
used. However, the effectiveness of these drugs is relatively low and their use is often associated with unpleasant
side effects. Specific ligands of receptors in the oesophageal mucosa and new inhibitors of transient lower oesophageal
sphincter relaxation are in development, and so the future might bring new therapeutic options for currently symptomatic
patients.