This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (37)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Gastrointestinal Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

Malcolm Robinson, MD; David Earnest, MD; Sheila Rodriguez-Stanley, PhD; Beverley Greenwood-Van Meerveld, PhD; Philip Jaffe, MD; Marianne T. Silver, MS; Christi S. Kleoudis, MPH; Lynn E. Wilson, BS; Robert H. Murdock, MAT

Arch Intern Med. 1998;158:2373-2376.

Background  Many otherwise healthy individuals with episodic heartburn self-medicate with over-the-counter antacids. We evaluated clinical characteristics of subjects who had never been medically diagnosed as having any upper gastrointestinal tract disorder and who used antacids for symptomatic relief of heartburn.

Subjects and Methods  Subjects with at least 3 months of frequent heartburn relieved by antacids, and with heartburn on at least 4 of 7 days during the week prior to study entry, had their medical history and gastrointestinal pathological characteristics recorded. Tests included esophagogastroduodenoscopy, esophageal motility and sensitivity studies, and 24-hour pH monitoring.

Results  Of 178 subjects screened, 13 were excluded on the basis of other gastrointestinal diseases at baseline, including diffuse esophageal spasm, peptic ulcer disease, dysplastic columnar metaplasia of the esophagus (Barrett's esophagus), and adenocarcinoma. Ten subjects were ineligible because of insufficient baseline heartburn. The remaining 155 eligible subjects had heartburn for an average of 11 years. Forty-seven percent had daily symptoms and 70% described heartburn severity as moderate, even though on endoscopy most (53%) had normal-appearing esophageal mucosa (grade 0 or 1). Esophageal acid sensitivity was present in 86% of subjects. Mean lower esophageal sphincter pressures and esophageal contractile amplitudes were at the lower limits of normal and total esophageal acid contact time was slightly increased.

Conclusions  Chronic heartburn can reflect a wide range of diagnostic findings, including important underlying pathological features, and may warrant a full medical examination to detect such abnormal conditions and to permit selection of appropriate therapy.

From the Oklahoma Foundation for Digestive Research, University of Oklahoma Health Sciences Center, Oklahoma City (Drs Robinson, Rodriguez-Stanley, and Greenwood-Van Meerveld); the University of Arizona Health Sciences Center, Tucson (Drs Earnest and Jaffe); and GlaxoWellcome Inc, Research Triangle Park, NC (Mss Silver, Kleoudis, Wilson, and Mr Murdock).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Self-Medication of Upper Gastrointestinal Symptoms: A Community Pharmacy Study
Mehuys et al.
The Annals of Pharmacotherapy 2009;43:890-898.
ABSTRACT | FULL TEXT  

Symptom evaluation in reflux disease: workshop background, processes, terminology, recommendations, and discussion outputs
Dent et al.
Gut 2004;53:iv1-iv24.
ABSTRACT | FULL TEXT