title: Heartburn in primary care: problems below the surface.
abstract: Heartburn is a common physiological event often associated with an underlying occurrence of gastroesophageal reflux disease (GERD). Studies show that GERD is a highly prevalent and chronic condition that significantly impacts on the patient's quality of life (QoL) and, in the long term, increases the risk for developing esophageal adenocarcinoma, more commonly referred to as Barrett's esophagus. Data indicate that symptom severity is a poor predictor of either the presence of erosive mucosal lesions or the development of complications. Given that lifestyle modifications are often insufficient for long-term treatment of GERD, drugs that inhibit gastric acid production--such as the proton pump inhibitors (PPIs)--are now the most effective strategy. Although generally well tolerated, the potential of PPIs for interactions with other drugs needs to be considered. This review discusses the symptoms and risk factors associated with GERD, possible links to Helicobacter pylori infection, and effective treatment strategies within a primary care setting.
authors.affiliation: Division of Internal Medicine, Department of Gastroenterology and Hepatology, University of Essen, Essen, Germany.
authors.forename: Gerald
authors.initials: G
authors.lastname: Holtmann
authors.forename: Evelyn
authors.initials: E
authors.lastname: Maldonado-Lopez
authors.forename: Sebastian
authors.initials: S
authors.lastname: Haag
mesh_terms: D000863:Antacids / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D006356:Heartburn / Q000175:diagnosis / Q000188:drug therapy; D016481:Helicobacter Infections / Q000453:epidemiology; D016480:Helicobacter pylori; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D008019:Life Style; D011320:Primary Health Care; D054328:Proton Pump Inhibitors; D011788:Quality of Life; D012008:Recurrence; D012307:Risk Factors
chemical_list: D000863:Antacids; D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors