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.

Randomised clinical trial: efficacy of the addition of a prokinetic, mosapride citrate, to omeprazole in the treatment of patients with non-erosive reflux disease - a double-blind, placebo-controlled study

“…Therefore, this condition is usually treated in primary care setting. However, GERD is known to impair patients’ quality of life 3 and they should be treated appropriately. As the impaired QOL is related to their symptoms, the therapeutic target should be symptom control, especially in NERD and mild reflux oesophagitis.…”

Response of Gastric Epithelial Progenitors to Helicobacter pylori Isolates Obtained from Swedish Patients with Chronic Atrophic Gastritis

“…The majority of colonized individuals remain asymptomatic and may even benefit from harboring this bacterium; for example, evidence is accumulating that colonization may offer protection against gastroesophageal reflux disease (1) and esophageal cancer (2, 3) as well as asthma and allergies (4). However, a minority of hosts go on to develop severe gastric pathology, including peptic ulcer disease and gastric cancer.…”

Pantoprazole 40 mg Is as Effective as Esomeprazole 40 mg to Relieve Symptoms of Gastroesophageal Reflux Disease after 4 Weeks of Treatment and Superior regarding the Prevention of Symptomatic Relapse

“…Gastroesophageal reflux disease (GERD) is a highly prevalent and chronic condition [1]. It is caused mainly by reflux of gastric content into the esophagus, leading to heartburn, acid regurgitation, and a variety of symptoms, like nausea, diarrhea or constipation, sleep disturbances, or other complaints, e.g., respiratory symptoms [2].…”