Esophagitis and its causes: Who is “guilty” when acid is found “not guilty”?

Figure 5 Diagnostic flow-chart proposed in patients with symptoms suggestive of esophagitis (heartburn, dysphagia, chest pain and others). The area above the dotted line includes all the possible manifestations of GERD that remains the most common etiology of symptoms. The less frequent causes are reported below the dotted line. All the possibilities deserve an accurate collection of clinical history to orientate the differential diagnosis. EoE: Eosinophilic esophagitis; NSAIDs: Non-steroidal anti-inflammatory drugs; IBD: Inflammatory bowel disease; GERD: Gastroesophageal reflux disease.