Figures & data
Figure 1. The evolution of reflux hypersensitivity (hypersensitive oesophagus) from Rome III to Rome IV. In Rome III, hypersensitive oesophagus is a subtype of non-erosive reflux disease. However, Rome IV separate hypersensitive oesophagus from NERD as a new functional oesophageal disease. And it should be noted that Rome IV states that RH can partially overlap with GERD.
Figure 2. Acid-sensitive receptors (nociceptors) such as TRPV1, ASICs, and PAR2 expressed by peripheral neurons or oesophageal epithelial cells are activated by protons or trypsin. Activation of nociceptors not only causes sensory nerve endings to release neurotransmitters such as CGRP and substance P to mediate neurogenic inflammation, but also transmits the information to the dorsal horn of the spinal cord (and from the dorsal horn of the spinal cord to the brain) thus leading to the occurrence of pain. (Figure by figdraw.).
