Differential diagnosis of heartburn refractory to proton pump inhibitors
| Erosive or reflux esophagitis |
| Nonerosive reflux disease |
| Eosinophilic esophagitis |
| Infectious esophagitis Viral (cytomegalovirus, herpes simplex virus) Fungal (Candida) |
| Pill-induced esophagitis Antibiotics (doxycycline, tetracycline) Nonsteroidal anti-inflammatory drugs and aspirin Bisphosphonates Potassium Quinidine |
| Esophageal motility disorder Achalasia Esophageal spasm or “jackhammer” esophagus Absent contractility, aperistalsis |
| Functional esophageal disorder Functional heartburn Reflux hypersensitivity |