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Functional heartburn is heartburn of unknown cause.[1] It is associated with other functional gastrointestinal disorders like irritable bowel syndrome and is the primary cause of lack of improvement post treatment with proton pump inhibitors (PPIs).[1] PPIs are however still the primary treatment with response rates in about 50% of people.[1] The diagnosis is based upon the Rome III criteria of 1) burning retrosternal discomfort 2) absence of GERD as the cause 3) no esophageal motility disorders.[1] It was found to be present in 22.3% of Canadians in one survey.[1]