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Curr Med Res Opin. 2010 Apr;26(4):759-65. doi: 10.1185/03007990903553812.

Role of the primary care provider in the diagnosis and management of heartburn.

Author information

1
Department of Family Medicine, University of California at Irvine, Irvine, CA, USA. pamkushner@hotmail.com

Abstract

BACKGROUND:

Heartburn affects an estimated 42% of the US population. Often, patients are able to recognize symptoms and self-treat heartburn; however, patients with more persistent and/or troublesome symptoms should be evaluated by a physician or other healthcare provider.

SCOPE:

This review focuses on the role of the primary care provider in the diagnosis and treatment of heartburn.

METHODS:

A search was conducted on PubMed (to November 2009) and articles relevant to the management of heartburn by a primary care provider topic were selected.

FINDINGS:

Diagnostic tools, such as endoscopy, and ambulatory pH monitoring, are recommended for advanced assessment of patients with frequent heartburn to avert misdiagnosis and to identify complications of reflux disease. Over-the-counter and prescription treatments for frequent heartburn symptoms include antacids, histamine(2)-receptor antagonists (H(2)RAs), antacid/H(2)RA combinations, and proton pump inhibitors (PPIs). Among these, PPIs represent the mainstay of acute and maintenance treatment regimens in reflux disorders and are more effective than H(2)RAs for long-term use due to the development of tolerance to the latter therapy. While once-daily PPI therapy may be sufficient in most patients, a few may require twice-daily PPI therapy to alleviate their symptoms. This review is limited by its relatively narrow focus on articles cited in PubMed.

CONCLUSION:

The primary care provider is ideally situated to advise patients on the best treatment option for their condition and to provide follow-up care if required.

PMID:
20095795
DOI:
10.1185/03007990903553812
[Indexed for MEDLINE]
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